Clinical Pediatrics最新文献

{"title":"Severe Acute Kidney Injury in a Child With Unilateral Hypoplastic Kidney.","authors":"Nihal Akçay, Demet Tosun, İlyas Bingöl, Oyhan Demirali","doi":"10.1177/00099228251340276","DOIUrl":"10.1177/00099228251340276","url":null,"abstract":"","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"1471-1474"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086094","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":"<i>Strongyloides</i> Seropositivity Among Children Utilizing a Mobile Clinic.","authors":"Lynda Aririguzo, Aditi Gupta, Norma Castillo, Cassandra Duran, Eva H Clark, Ankona Banerjee, Sanghamitra Misra","doi":"10.1177/00099228251375274","DOIUrl":"https://doi.org/10.1177/00099228251375274","url":null,"abstract":"<p><p>Experts recommend screening for or presumptively treating strongyloidiasis in foreign-born immigrant children, though prevalence is unknown. Health care providers encounter barriers to following this recommendation. We aimed to describe <i>Strongyloides</i> seropositivity and risk factors among pediatric patients on a mobile clinic. Participants completed a written survey and provided blood for absolute eosinophil count (AEC) and <i>Strongyloides</i> IgG enzyme-linked immunosorbent assay (ELISA). From October 2022 to June 2023, 206 patients participated; 201 (97.6%) were born outside the United States; 97.1% (n = 200) were Hispanic. Most (68.9%) arrived less than 1 year before study enrollment. Four (1.9%) and 3 (1.5%) had positive and equivocal ELISA results, respectively. Peripheral eosinophilia was seen in 27 participants (13%). Previous antiparasitic use was reported by 106 (51.5%). We found no significant associations between <i>Strongyloides</i> seropositivity and AEC, exposures, symptoms, or medical history. Mobile clinics can feasibly conduct strongyloidiasis prevalence studies to create guidelines for providers who see foreign-born immigrant children.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"99228251375274"},"PeriodicalIF":0.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191286","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 Mental and Behavioral Health Services Available to Children With Medical Complexity in Complex Care Programs.","authors":"Kristina E Malik, Charlene Shelton, Amber Marin, Verenea J Serrano, Bruno J Anthony, Edward L Schor, Ricardo A Mosquera, Carlos Lerner, Christopher J Stille","doi":"10.1177/00099228251372723","DOIUrl":"https://doi.org/10.1177/00099228251372723","url":null,"abstract":"<p><p>We conducted a cross-sectional survey of complex care programs on behavioral health services provided to children with medical complexity (CMC). Quantitative and qualitative data were analyzed by using convergent mixed methods. Rates of CMC receiving behavioral health services were at or above national averages for the general pediatric population and the most reported concerns were externalizing behaviors. Of 25 programs, 7 (28%) reported integrated care and programs with integrated care found the service improved access and were more likely to screen for caregivers' mental health. Themes included: 1. Current models of care for pediatric mental and behavioral health limits access for CMC; 2. Collaboration is highly desired by medical teams; 3. Providing mental health for family members of CMC is important. Despite high service use and frequent availability of integrated care, complex care programs still report insufficient access to behavioral health services required to meet the needs of CMC.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"99228251372723"},"PeriodicalIF":0.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191379","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":"Factors Associated With Exceeding Predicted Hospital Stays in Pediatric Trauma Patients.","authors":"Michelle C Coughlin, Elika Ridelman, Lydia J Donoghue, Christina M Shanti","doi":"10.1177/00099228251376861","DOIUrl":"https://doi.org/10.1177/00099228251376861","url":null,"abstract":"<p><strong>Background: </strong>The Center for Medicare and Medicaid Services (CMS) calculates predicted length of stay (LOS) for specific diagnosis-related groups and ties it to reimbursement. The Injury Severity Score (ISS) and the presence of non-accidental trauma (NAT) have been associated with longer hospital stays in pediatric trauma patients. To what extent do those and other factors in the pediatric trauma patient impact the CMS-predicted LOS is unknown. This study aims to identify factors in our patients where practice change may reduce LOS.</p><p><strong>Methods: </strong>A retrospective chart review was conducted of 1005 pediatric trauma patients admitted to our urban, academic Level 1 Trauma Center from January 2018 to December 2020, who met inclusion criteria. Patient data were analyzed with a significance given of <i>P</i> < .05.</p><p><strong>Results: </strong>A total of 177 (17.6%) patients exceeded their CMS-predicted LOS. These patients had greater admissions to the ICU (56.1% vs 13.8%; <i>P</i> = .000), confirmed-NAT (11.6% vs 3.3%; <i>P</i> = .000), child protective service involvement (33.1% vs 21.3%; <i>P</i> = .001), intubations (36.0% vs 5.4%; <i>P</i> = .000), ventilator days (3.66 vs 0.23; <i>P</i> = . 000), transfusions (26.7% vs 3.0%; <i>P</i> = .000), and discharges to inpatient rehab (21.5% vs 1.6%; <i>P</i> = .000). They presented with a higher ISS (16.0 vs 7.0; <i>P</i> = .000). Etiologies associated with excessive LOS included motor-vehicle-crashes (22.1% vs 12.9%; <i>P</i> = .001), motor-vehicle vs pedestrian (10.5% vs 6.5%; <i>P</i> = .032), and suspected abuse (14% vs 5.1%; <i>P</i> = .000). Patients with excessive LOS had a higher likelihood of brain injury (48.8% vs 21.3%; <i>P</i> = .000) and internal organ injury (22.7% vs 6.9%; <i>P</i> = .000). They had more imaging studies (2.01 vs 1.51; <i>P</i> = .000), including more CT (68.6% vs 49.3%), MRI (22.7% vs 6.8%), and ultrasound (37.2% vs 22.6%) use. Patients who exceeded LOS underwent more surgical procedures (1.2 vs 0.6; <i>P</i> = .000), with a longer time from admission to operating room (1.92 vs 0.76 days; <i>P</i> = .001) and longer operative times (113.1 vs 40.0 minutes; <i>P</i> = .000). They more frequently required intervention by general surgery (5.8% vs 2.1%), neurosurgery (16.9% vs 1.6%), or multiple surgical teams (15.1% vs 3.7%). They had lower rates of intervention by other surgical subspecialties.</p><p><strong>Conclusions: </strong>A proportion of admitted pediatric trauma patients exceeded their CMS-predicted LOS, influencing hospital reimbursement. Our study identifies factors associated with excessive LOS related to patient demographics, trauma etiologies, and inpatient courses. These factors, particularly concerning patient care, should be considered to improve LOS predictions and to reduce actual LOS.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"99228251376861"},"PeriodicalIF":0.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184697","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":"A Rare Cause of Lemierre's Syndrome.","authors":"Jonathan Askins, Jacob F Filipek, Kristyn Jeffries","doi":"10.1177/00099228251380111","DOIUrl":"https://doi.org/10.1177/00099228251380111","url":null,"abstract":"","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"99228251380111"},"PeriodicalIF":0.7,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184711","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":"<i>Dientamoeba fragilis</i> Infection Mimicking Appendicitis Case Report: New Differential Diagnosis Considerations.","authors":"Jason T Tsichlis, Gaspar Rivera","doi":"10.1177/00099228251375262","DOIUrl":"https://doi.org/10.1177/00099228251375262","url":null,"abstract":"","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"99228251375262"},"PeriodicalIF":0.7,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184687","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":"Feeding Issues Among Preschoolers With Developmental Concerns and Risks From a Developmental Pediatrics Perspective: A Cross-Sectional Study From an Eurasian Country.","authors":"Emel Omercioglu, Ayse Mete Yesil, Ebru Ozturk, Gokcenur Ozdemir, Buse Sencan, Elif N Ozmert","doi":"10.1177/00099228251375538","DOIUrl":"https://doi.org/10.1177/00099228251375538","url":null,"abstract":"<p><p>This study sought to examine the association between feeding difficulties and the developmental and behavioral profiles of preschool children (n = 102) with developmental risks referred to a developmental pediatrics clinic. The Ages and Stages Questionnaire, the Ages and Stages Questionnaire: Social-Emotional, the Child Behavior Checklist, and the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) were utilized for all participants. A multiple linear regression analysis revealed a significant association between feeding issues and behavioral problems, whereas no such relationship was found with developmental domains. Positive correlations were observed across all behavioral problems and BPFAS subscales. The literature on children's feeding issues is varied, focusing on those with severe developmental delays or neurodevelopmental disorders. However, rising admissions for milder delays, particularly in developing countries, underscore the need for comprehensive intervention. It is crucial to address these children's feeding problems by considering medical, developmental, and particularly behavioral factors, given nutrition's critical role in growth and development.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"99228251375538"},"PeriodicalIF":0.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136780","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":"Documentation of Pregnancy Options Counseling in a Pediatric Emergency Department and Outpatient General Pediatric Clinic: A Single-Center Retrospective Study.","authors":"Miriam Brown, Haley N Fitzgerald, Saidat Sola Rufai, Lauren A Bell, Tahniat Syed, Laura Kirkpatrick","doi":"10.1177/00099228251372395","DOIUrl":"10.1177/00099228251372395","url":null,"abstract":"<p><p>We reviewed electronic health record documentation of outpatient and emergency department (ED) visits with a positive pregnancy test from January 1, 2014, to June 1, 2021, within a tertiary-care pediatric system for documentation of pregnancy options counseling. We excluded encounters where patients were admitted or referred/transferred to another ED, or nurse-only visits. Of 88 eligible encounters, 51/88 (58%) occurred in the ED and 37/88 (42%) in outpatient clinic. Options counseling was documented in 20 encounters (23%), including 6/51 (12%) of ED visits and 14/37 (38%) of clinic visits. By logistic regression adjusting for age, race, insurance type, and prior positive pregnancy test, options counseling documentation was significantly more likely for outpatient clinic visits than the ED (aOR = 4.80, 95% CI = 1.52-15.18, <i>P</i> = .008). Rates of documentation of options counseling in pediatric settings are low and are lower for ED than outpatient visits, suggesting low rates of options counseling in pediatric practice.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"99228251372395"},"PeriodicalIF":0.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136638","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":"Bullous Cutaneous Lesions in Pediatrics: A Diagnostic Challenge.","authors":"Marcos Medina Bethencourt, Francisco José García Díaz, Claudia Andrade Díaz, Blanca Lanero Olivencia, Isabel Martínez Carapeto","doi":"10.1177/00099228251375917","DOIUrl":"https://doi.org/10.1177/00099228251375917","url":null,"abstract":"","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"99228251375917"},"PeriodicalIF":0.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136693","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 Pediatric Cases With Cholelithiasis: 5-Year Single-Center Experience.","authors":"Hilal Koyuncu, Ayşe Tolunay Oflu, Ayşe Güngör, Ayşegül Bükülmez","doi":"10.1177/00099228251372717","DOIUrl":"https://doi.org/10.1177/00099228251372717","url":null,"abstract":"<p><p>Gallstones are sometimes detected as a cause of a clinical finding in children and sometimes incidentally. This study aimed to investigate the demographic and clinical characteristics of pediatric patients with gallstones. Pediatric cases diagnosed with gallstones between 2017 and 2023 in a tertiary hospital were retrospectively examined. A total of 65 patients were included in the study. The mean age of the cases was 10.8 ± 5.3 years, and 44 (67.7%) were adolescents. The most common complaint of the cases was abdominal pain (60%), and 33.8% were diagnosed incidentally. Obesity was the most frequently identified cause (26.2%) and was significantly higher in adolescents. Forty-five (69.2%) cases were symptomatic, and 10 (15.3%) were complicated. This study found that the frequency of gallstones in children increases with age, and that the underlying cause is likely to be obesity as age increases. Clinicians should avoid medications that may cause gallstones in obese adolescents.</p>","PeriodicalId":10363,"journal":{"name":"Clinical Pediatrics","volume":" ","pages":"99228251372717"},"PeriodicalIF":0.7,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130077","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}