Current opinion in pediatrics最新文献

{"title":"Utility of the Coleman block test.","authors":"Caroline Cristofaro, Maryse Bouchard","doi":"10.1097/MOP.0000000000001509","DOIUrl":"10.1097/MOP.0000000000001509","url":null,"abstract":"<p><strong>Purpose of review: </strong>The Coleman block test is a key component of the foot and ankle physical examination in children and adults. This review describes the Coleman block test and summarizes its implications in surgical decision making as well as its limitations.</p><p><strong>Recent findings: </strong>The Coleman block test is a classic technique for evaluating whether the hindfoot deformity in a cavovarus foot is flexible or rigid. It involves placing a wooden block underneath the lateral column of the foot to remove the effect of the plantarflexed first ray of the cavus deformity and assessing whether the hindfoot varus subsequently corrects into valgus. When the hindfoot is flexible, only the cavus requires surgical correction. However, if the hindfoot varus is rigid, additional correction is needed, typically a lateral displacement osteotomy of the posterior calcaneus. More recent modifications to the test include radiographic evaluation of the foot while on the block, and a modification for block placement that is particularly useful in children.</p><p><strong>Summary: </strong>The Coleman block test is a simple clinical test should be performed routinely when assessing cavovarus deformities to help devise the most appropriate surgical plan.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"87-92"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scoliosis, leg length discrepancy, or both?","authors":"Fernando Moreno Mateo, Rosa M Egea-Gámez, Osman M Mahboob","doi":"10.1097/MOP.0000000000001528","DOIUrl":"10.1097/MOP.0000000000001528","url":null,"abstract":"<p><strong>Purpose of review: </strong>Scoliosis and limb length discrepancy (LLD) are frequent findings in pediatric orthopedic practice. Because both conditions can alter posture and spinal alignment, distinguishing between a compensatory spinal curvature due to LLD and a true structural scoliosis is crucial. This review explores the relationship between scoliosis and LLD in children, emphasizing recent evidence and clinical strategies for accurate diagnosis and management.</p><p><strong>Recent findings: </strong>Minor limb length discrepancies are common in the general population. However, significant LLD (defined as >2 cm) can produce pelvic tilt and a functional scoliosis, which typically resolve when the LLD is corrected. Even smaller discrepancies (<2 cm) may contribute to spinal curvature in growing children, and correcting these differences may reduce the Cobb angle of a functional scoliosis. Additionally, after surgical correction of structural scoliosis, compensatory LLD often improves, reflecting the complex biomechanical relationship between the spine and lower limbs.</p><p><strong>Summary: </strong>LLD and scoliosis can mimic or exacerbate one another, making careful evaluation essential in pediatric patients. True structural scoliosis must be differentiated from a functional scoliosis secondary to LLD. An accurate assessment of leg lengths should be part of the routine evaluation for any child with scoliosis. When a significant LLD is identified as the cause of spinal curvature, appropriate treatment, such as shoe lifts or surgical correction of the limb inequality, might correct the spinal curvature in the coronal plane. In contrast, in idiopathic scoliosis with a minor coexisting LLD, treatment should primarily address the spinal deformity.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"93-99"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145631170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of pediatric bone sarcomas.","authors":"Leighton Elliott, David M Loeb, Matteo Trucco","doi":"10.1097/MOP.0000000000001535","DOIUrl":"10.1097/MOP.0000000000001535","url":null,"abstract":"<p><strong>Purpose of review: </strong>Pediatric bone sarcomas - principally osteosarcoma (OS) and Ewing sarcoma (ES) - remain curable for many with localized disease, but outcomes for metastatic or relapsed cases have stagnated. We synthesize recent clinically relevant developments that inform diagnosis, risk stratification, local control, systemic therapy, and survivorship in children and adolescents.</p><p><strong>Recent findings: </strong>Standard frontline therapy has not changed in decades for OS and ES. Maturing evidence for new technologies such as circulating tumor DNA (ctDNA) raises questions of how to validate and incorporate these tools into treatment regimens to improve outcomes for children with bone sarcomas. In OS, the debate between a minimally invasive approach to pulmonary metastasectomy over open thoracotomy remains; attempts to address this debate are underway. Improving survival continues to pose a great challenge. Adding tyrosine kinase inhibition to chemotherapy is the current strategy to improve upfront therapy, while a more radical approach of frequently changing drug combinations in the upfront setting, in an attempt to evade resistance, is also being tested in OS and ES. While the rEEcur trial attempted to compare chemotherapeutic regimens for relapsed ES, better understanding of the underlying biological nature of OS and ES are necessary for development of novel treatment strategies. Long-term survivorship care remains a global focus for various national consortia.</p><p><strong>Summary: </strong>Although the activity of single-agent checkpoint inhibitors remains disappointing in pediatric bone tumors, rational tyrosine kinase inhibitor-chemotherapy combinations, improved biologic risk stratification (ctDNA; MYC in OS; STAG2 in ES), recycling chemotherapeutic agents, and standardized local-control frameworks are being developed to reshape care. Near-term priorities include biomarker-anchored upfront trials and supportive-care measures that preserve cure while reducing late effects. Clinical trials provide access to potentially paradigm-shifting therapeutic strategies.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"45-52"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the gaps: key insights of mobile dyadic postpartum care models.","authors":"Rosha N Forman, Alice B Cruikshank, Michelle L Stransky","doi":"10.1097/MOP.0000000000001533","DOIUrl":"10.1097/MOP.0000000000001533","url":null,"abstract":"<p><strong>Purpose of review: </strong>Mobile healthcare is an innovative solution to address barriers to postpartum and infant visits among underserved communities. The purpose of this review is to describe how mobile postpartum care can improve the health and well being of birthing people and their infants.</p><p><strong>Recent findings: </strong>Many mobile healthcare programs for postpartum dyads exist, but few are discussed in the literature. Key themes of existing programs are a focus on meeting patients in their communities, providing care to the birthing person and infant in a single encounter and setting, advanced practice nursing leadership and staffing, and screening for health-related social needs.</p><p><strong>Summary: </strong>Mobile healthcare is an innovative solution to reduce barriers to postpartum care, given the intrinsic relationship between the health and well being of birthing persons and their infants.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"25-30"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving food as medicine programs to advance health equity: insights from two decades of practice.","authors":"Olivia Thomas, Cristina M Gago, Kelsey A Egan, Richard Sheward, Kate G Burt","doi":"10.1097/MOP.0000000000001531","DOIUrl":"10.1097/MOP.0000000000001531","url":null,"abstract":"<p><strong>Purpose of review: </strong>The Food as Medicine (FAM) movement has gained momentum as a strategy to address food insecurity and manage diet-related chronic conditions by integrating food prescriptions, medically tailored meals, and culinary and nutrition education into clinical care. However, few FAM programs have evaluated long-term sustainability, equity outcomes, or structural impact on systems-level change beyond food insecurity in the hospital setting alone. This case study reviews feasible, equity-centered evaluation strategies leveraged by the Nourishing Our Community Program (NoC) at Boston Medical Center (BMC), one of the country's oldest and most comprehensive health system-based FAM initiatives.</p><p><strong>Recent findings: </strong>We trace the historical development of NoC, highlighting key adaptations in evaluation strategy and outlining embedded data collection methods across clinical and community settings. The evaluation approach captures both traditional metrics (e.g., food insecurity screening outcomes) and broader measures, including patient experience, cultural relevance, and local economic impact.</p><p><strong>Summary: </strong>By embedding equity into every stage of program design and assessment, this case study provides a replicable framework for health systems aiming to sustain and scale food-based interventions. It also contributes to the limited but growing body of literature on systems-level implementation of FAM programs that address both individual health outcomes and structural drivers of inequity.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"31-39"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal social health - a prerequisite to improving child health.","authors":"Lucy E Marcil, Nina S Mazzacco, Amy Lewis Gilbert, Shambra Mulder, Nancy Connolly","doi":"10.1097/MOP.0000000000001532","DOIUrl":"10.1097/MOP.0000000000001532","url":null,"abstract":"<p><strong>Purpose of review: </strong>Mothers in the United States are unwell, with high rates of maternal stress and death. Maternal health matters in its own right, and it is more difficult for children to be well if their parents are not. Improving mothers' economic status and social connectedness to improve maternal and child health has received increased attention.</p><p><strong>Recent findings: </strong>New data build on previous findings that economic (e.g., financial strain, lost health insurance) and social [e.g., adverse childhood experiences (ACEs), structural racism] stressors are associated with poorer maternal and child health. Conversely, economic and social supports (e.g., cash transfers, paid family and medical leave, social connectedness) improve aspects of maternal and child health. Evidence on whether pandemic-era cash transfers impact maternal and child health is mixed.</p><p><strong>Summary: </strong>Addressing social and economic stressors can improve maternal and child health, but the details matter. Incremental economic interventions are insufficient. Social factors such as isolation and structural racism must also be addressed. Policy implementation is equally important; families cannot benefit if they cannot access resources. Policy changes such as universal paid family and medical leave are needed. The field of pediatrics should update practice guidelines and advocate for policy changes.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":"38 1","pages":"1-8"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update on pediatric soft tissue sarcomas.","authors":"Jamie Aye, Jacquelyn Crane, Sapna Oberoi","doi":"10.1097/MOP.0000000000001526","DOIUrl":"10.1097/MOP.0000000000001526","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review is to highlight recent findings in the diagnosis, biology, risk-stratification, and treatment of soft tissue sarcomas (STS) in children.</p><p><strong>Recent findings: </strong>In rhabdomyosarcoma (RMS), FOXO1 fusion status has been confirmed as an important prognostic factor. Among fusion-negative RMS, TP53 and MYOD1 mutations and detectable circulating tumor DNA at diagnosis are associated with inferior event-free survival in intermediate-risk disease. Delayed primary excision is associated with a reduced risk of local failure whereas radiotherapy dose escalation in large tumors has not improved local control. Maintenance therapy with vinorelbine and oral cyclophosphamide following induction chemotherapy in the RMS2005 trial led to improved survival. In non-rhabdomyosarcoma soft tissue sarcomas, the addition of pazopanib, a multitargeted receptor tyrosine kinase inhibitor, to upfront therapy did not improve survival. Atezolizumab is approved for alveolar soft part sarcoma, larotrectinib for NTRK fusion-positive STS, and afamitresgene autoleucel remains under evaluation in children with synovial sarcoma. Encouraging early results have been reported with tazemetostat and immune checkpoint inhibitors in epithelioid sarcoma and trastuzumab in desmoplastic small round cell tumor, respectively.</p><p><strong>Summary: </strong>Pediatric STS are rare and biologically heterogeneous. Genomic advances have refined risk stratification and uncovered therapeutic targets; further progress relies on international collaboration and trials.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":"38 1","pages":"53-64"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early childhood education matters for child, family, and community health.","authors":"Kyle DeMeo Cook, Genevieve G Guyol","doi":"10.1097/MOP.0000000000001529","DOIUrl":"10.1097/MOP.0000000000001529","url":null,"abstract":"<p><strong>Purpose of review: </strong>Strong evidence shows that early childhood education (ECE) impacts child health and wellbeing throughout the life course. Contextual factors including the rising cost of ECE and the strain of the COVID-19 pandemic on childcare arrangements have ignited national conversations about ECE. We build on existing evidence to propose a conceptual model that demonstrates mechanisms of multilevel health impacts.</p><p><strong>Recent findings: </strong>There is increasing recognition that ECE influences health beyond the level of the child to impact health at the levels of parent/family and community. Innovations in medical and ECE settings and cross-sector efforts can improve multilevel health outcomes by leveraging the healthcare platform to improve access to ECE, integrating mental health supports into ECE settings, and facilitating communication and data sharing between the two systems.</p><p><strong>Summary: </strong>We integrate insights from multiple early childhood disciplines, including psychology, education, and medicine to propose a model for the impacts of ECE on multilevel health outcomes. This model highlights the importance of cross-disciplinary approaches to realize the full health benefits of ECE and can inform future research and advocacy. We highlight the need for pediatricians to work across early childhood disciplines to achieve greater impact on comprehensive wellbeing.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"9-14"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transition to adulthood for neurodivergent youth.","authors":"Bianca Chandler, Samantha Mosoff, Alexis Tchaconas","doi":"10.1097/MOP.0000000000001536","DOIUrl":"10.1097/MOP.0000000000001536","url":null,"abstract":"<p><strong>Purpose of review: </strong>To provide an overview of neurodivergence and its unique challenges across the lifespan, including best practices for pediatricians who care for these individuals and facilitate their transition to adulthood.</p><p><strong>Recent findings: </strong>Neurodivergent individuals, those with a natural variation in human neurological functioning, represent a growing population, accounting for nearly one-fifth of the U.S. population. They experience worse health outcomes in adulthood compared with their neurotypical peers due to lack of clinician training in addressing their unique needs, loss of essential therapy services previously provided by the public education system, lapses in benefits and insurance coverage, ambiguities in decision-making, and incomplete long-term planning. When neurodivergent affirming care is provided, health outcomes and patient satisfaction improve significantly.</p><p><strong>Summary: </strong>Neurodivergent youth encounter specific challenges throughout the lifespan, which are compounded during the transition from pediatric to adult systems. In addition to varied healthcare access and a range of decision-making abilities, there are also important considerations for community integration and long-term planning.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"117-125"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atlantoaxial rotatory fixation.","authors":"Peter M Cirrincione, Jessica H Heyer","doi":"10.1097/MOP.0000000000001510","DOIUrl":"10.1097/MOP.0000000000001510","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review provides the most up to date information on diagnosing and treating atlantoaxial rotatory fixation (AARF). The condition can be confused with torticollis, but primary care physicians should have a high index of suspicion for AARF as timely noninvasive treatment facilitates excellent outcomes.</p><p><strong>Recent findings: </strong>A variety of etiologies have been described to cause AARF, but is most commonly seen following a viral infection of the upper respiratory system. When diagnosed early, nonoperative measures including rest, cervical collars, and antiinflammatories/muscle relaxants can allow for full resolution, avoidance of surgery and excellent outcomes.</p><p><strong>Summary: </strong>Atlantoaxial rotatory fixation is a treatable condition without need for surgery in most cases. Dynamic computed tomography scan is the imaging modality of choice to diagnose and confirm resolution of the condition, as diagnosis requires documented pathologic subluxation between the first and second cervical vertebrae.</p>","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":"73-80"},"PeriodicalIF":2.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}