JAMA Pediatrics最新文献

{"title":"Montelukast Use and the Risk of Neuropsychiatric Adverse Events in Children.","authors":"Viktor Wintzell,Philip Brenner,Linda Halldner,Samuel Rhedin,Tong Gong,Catarina Almqvist","doi":"10.1001/jamapediatrics.2024.5429","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.5429","url":null,"abstract":"ImportanceSpontaneous reports have indicated that montelukast increases the risk of neuropsychiatric adverse events, and the US Food and Drug Administration added a boxed warning about these risks in 2020. However, the potential mechanism is not well understood, and the observational evidence is scarce, particularly in children.ObjectiveTo assess the potential association between the use of montelukast and the risk of neuropsychiatric adverse events in children and adolescents.Design, Setting, and ParticipantsThis nationwide register-based cohort study used data from Sweden from January 1, 2007, to November 30, 2021. Participants included children aged 6 to 17 years who used montelukast and long-acting β-agonists (LABA). Data analysis was performed from December 2023 to April 2024.ExposureMontelukast vs LABA.Main Outcomes and MeasuresThe primary outcome, any neuropsychiatric adverse event, was a composite of secondary outcomes, including anxiety; depression; sleep-related disorders; suicide and suicidal actions; disrupted control of activity, attention, and behavior; and confusion and psychotic-like symptoms. Outcomes were defined on the basis of diagnosis codes and dispensings of prescription drugs for specific neuropsychiatric symptoms. Patients were followed up from drug initiation to discontinuation, and treatment and censoring weights were used to adjust for potential confounding on baseline and selection bias from informative censoring. Pooled logistic regression was used to estimate hazard ratios (HRs).ResultsThe final cohort included 74 291 children (mean [SD] age, 12.3 [3.3] years; 35 446 female [47.7%]); 26 462 used montelukast and 47 829 used LABA. During a mean (SD) follow-up of 5.8 (3.2) months, 310 neuropsychiatric adverse events in the montelukast patients and 566 events in the LABA patients were identified. In the weighted cohort, the incidence rates of neuropsychiatric adverse events were 2.39 per 100 patient-years among the montelukast users and 2.41 per 100 patient-years among the LABA users. This translated to a weighted HR of 0.99 (95% CI, 0.84-1.16). No substantial differences were observed between the montelukast and LABA patients when analyzing the risk of specific neuropsychiatric adverse events: the HRs were 0.79 (95% CI, 0.54-1.14) for anxiety; 1.16 (95% CI, 0.70-1.95) for depression; 0.93 (95% CI, 0.76-1.13) for sleep-related disorders; 1.31 (95% CI, 0.64-2.69) for suicide and suicidal actions; 1.27 (95% CI, 0.84-1.90) for disrupted control of activity, attention, and behavior; and 0.51 (95% CI, 0.05-5.53) for confusion and psychotic-like symptoms. The risk of the primary outcome was consistent over subgroups and a range of sensitivity analyses.Conclusions and RelevanceIn this large study of children and adolescents based on data from routine clinical practice, there was no association between use of montelukast and the risk of neuropsychiatric adverse events. In aggregation with other robust observational studies, the","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"25 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142991749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood Traumatic Brain Injury and Crime in Adolescence-Reply.","authors":"Ea Hoppe Blaabæk,Felix Elwert,Peter Fallesen","doi":"10.1001/jamapediatrics.2024.6399","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.6399","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"103 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142991735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of a Population-Based Congenital Cytomegalovirus Screening Program.","authors":"Jessica K E Dunn,Pranesh Chakraborty,Emily Reuvers,Lauren Gallagher,Kristin D Kernohan,Melanie Lacaria,Michelle Barton,Kirk Leifso,Jeffrey M Pernica,Emeril Santander,Marie Pigeon,Sharon L Cushing,Johnna MacCormick,Soren Gantt,Stacey Weber,Ari Bitnun,Jason Brophy","doi":"10.1001/jamapediatrics.2024.5562","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.5562","url":null,"abstract":"ImportanceDetection of congenital cytomegalovirus (cCMV) infection has previously relied on targeted screening programs or clinical recognition; however, these approaches miss most cCMV-infected newborns and fail to identify those infants who are asymptomatic at birth but at risk for late-onset sensorineural hearing loss.ObjectiveTo determine the feasibility of using routinely collected newborn dried blood spots (DBS) in a population-based cCMV screen to identify infants at risk for hearing loss and describe outcomes of infants screened.Design, Setting, and ParticipantsThis diagnostic study of a population-based screening program in Ontario, Canada, took place from July 29, 2019, to July 31, 2023. All newborns with a DBS sample collected as part of routine care were screened using polymerase chain reaction (PCR) analysis for cCMV as a risk factor for hearing loss. Infants with positive DBS PCR results for cCMV were referred for confirmation of infection by urine PCR (the gold standard), as well as complete medical and audiologic assessments for sequelae of cCMV infection. Infants with possible or confirmed symptomatic cCMV were referred to pediatric infectious disease specialists for evaluation for potential treatment with valganciclovir.ExposureDetection of cCMV by polymerase chain reaction assay on a newborn DBS.Main Outcomes and MeasuresNumber of infants with positive screening results successfully retrieved and confirmed to have cCMV and the timeliness of retrieval and symptomatic evaluation.ResultsOf 565 987 infants born in the screening period, 551 034 (97.4%) received cCMV screening on the DBS (45.7% female, 54.3% male). Of these infants, 689 (0.13%) screened positive for cCMV; 601 (87.2%) had cCMV infection confirmed and a complete assessment of sequelae of their congenital infection. Ninety-six infants with completed assessments (16.0%) were deemed to have cCMV symptoms, and 63 of these (65.6%) began valganciclovir treatment. Sensorineural hearing loss was confirmed in 34 of 96 infants (35.4%).Conclusions and RelevanceThis program found acceptable and feasible implementation of a population-based screening program using routinely collected DBS samples, suggesting that it may serve as a template for jurisdictions considering universal cCMV screening. The program had a much lower than expected prevalence of cCMV-positive screens but still identified many children who would otherwise not have been diagnosed and who would benefit from ongoing audiologic surveillance.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"74 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142991733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Childhood Traumatic Brain Injury and Crime in Adolescence.","authors":"Thomas M McMillan,Joseph A Schwartz,Huw Williams","doi":"10.1001/jamapediatrics.2024.6402","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.6402","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"9 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142991732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatrician Perspectives on Incorporating Discussion of Police Encounters Into Anticipatory Guidance for Black Youth and Their Caregivers","authors":"Jeffrey M. Eugene, Maria Nelson, Rebecca Neergaard, Emma Edmondson, Sarah Capponi, M. Christina Herrera, Judy A. Shea, Katherine Yun, Nicole Jaffe, Julie Premo, George Dalembert","doi":"10.1001/jamapediatrics.2024.6167","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.6167","url":null,"abstract":"This study explores the barriers and facilitators to pediatricians discussing safely navigating police interactions with Black youth and their caregivers.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"36 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Prevalence of Sexual Violence Against Children","authors":"Antonio Piolanti, Iason E. Schmid, Fabian J. Fiderer, Catherine L. Ward, Heidi Stöckl, Heather M. Foran","doi":"10.1001/jamapediatrics.2024.5326","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.5326","url":null,"abstract":"ImportanceSexual violence against children is a global concern, yet worldwide figures of its prevalence are scant.ObjectiveTo estimate the global prevalence of sexual violence against children using national-level population-based studies.Data SourcesWe searched the PubMed, Embase, CINAHL, Web of Science, PsycINFO, ERIC, and APA PsycArticles databases from their respective inceptions to March 2022. Searches were updated through April 2024.Study SelectionReports were included if (1) they were national-level population-based studies, (2) they reported lifetime or past-year prevalence data on any form of sexual violence against children (mean age ≤19 years), and (3) the data were based on children’s self-reports of sexual violence perpetrated by anyone.Data Extraction and SynthesisData extraction included study and participant characteristics, prevalence rates, and types of sexual violence. Outcomes were pooled using a random-effects model. Exploratory subgroup analyses were performed with categorical moderators.Main Outcomes and MeasuresPrimary outcomes included lifetime and past-year prevalence of forced sexual intercourse, contact sexual violence, and sexual harassment.ResultsWe identified 165 studies that included 958 182 children from 80 countries, with the majority of data focusing on girls (58.2%). The sample sizes of the studies ranged from 330 to 132 948; the mean age ranged from 10.5 to 19.4 years. Lifetime sexual harassment was the most prevalent outcome, with a pooled rate of 11.4% (95% CI, 8.5%-15.1%), followed by any contact sexual violence, with a rate of 8.7% (95% CI, 4.7%-15.5%). Furthermore, 6.1% (95% CI, 5.1%-7.3%) of children reported experiencing completed forced sexual intercourse in their lifetime, and 1.3% (95% CI, 1.0%-1.7%) reported experiencing it in the preceding year. Rates of lifetime completed forced sexual intercourse were higher among girls (6.8% [95% CI, 6.1%-7.6%]) compared with boys (3.3% [95% CI, 2.5%-4.3%]), similar to past-year violence (2.3% [95% CI 1.9%-2.7%] for girls and 0.6% [95% CI 0.4%-0.9%] for boys). We found considerable variation across regions and countries in the reported prevalence of sexual violence. Older age of children, lower national income levels, and the use of school-based surveys were associated with higher rates of sexual violence reporting in some exploratory analyses.Conclusions and RelevanceThe findings of this systematic review and meta-analysis highlight the burden of sexual violence against children worldwide based on current available evidence. There is a pressing need to enhance data collection efforts globally, especially in underresearched regions and for boys.Study RegistrationPROSPERO <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"uri\" xlink:href=\"https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022327090\">CRD42022327090</jats:ext-link>","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"50 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medicaid and the Promise for Cure","authors":"Sophie Cain Miller, Mohammad H. Dar, S. Maria E. Finnell, Douglas G. Fish, Christopher R. Cogle","doi":"10.1001/jamapediatrics.2024.5100","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2024.5100","url":null,"abstract":"ImportanceCell and gene therapies are revolutionizing the treatment landscape for children and adults with rare diseases and can be life-changing for patients and their families. Successful implementation of these new therapies into clinical practice depends on their accessibility and affordability, particularly through publicly funded Medicaid agencies, which cover many children and adults with rare diseases.ObjectiveTo provide a framework to broadly assess cell and gene therapies, evaluate payment options, and ensure equitable access through the lens of publicly funded Medicaid programs.Evidence ReviewThis review draws on peer-reviewed articles, federal reports, and other relevant publications as well as the expertise of chief medical officers and medical directors of state Medicaid agencies across 5 diverse states.FindingsTwenty-nine articles and other references provide the foundation for this review. The recommendations presented focus on thoughtful implementation of cell and gene therapies, including policy recommendations in the domains of safety, effectiveness, population health, access, and budget.Conclusions and RelevanceProposed health care policy changes are intended to balance innovation, affordability, and equitable access for children and adults with rare diseases.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"15 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence That Intervention Dosage Is Associated With Better Outcomes in Autism.","authors":"Thomas W Frazier, Lacey Chetcuti, Mirko Uljarevic","doi":"10.1001/jamapediatrics.2024.4710","DOIUrl":"10.1001/jamapediatrics.2024.4710","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":"101-102"},"PeriodicalIF":24.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Exclusivity Revenues for Cancer Drugs.","authors":"Ameet Sarpatwari, Liam Bendicksen, Douglas S Hawkins, Lia Gore, Florence T Bourgeois","doi":"10.1001/jamapediatrics.2024.4449","DOIUrl":"10.1001/jamapediatrics.2024.4449","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":"91-93"},"PeriodicalIF":24.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal Obesity and Sudden Unexpected Infant Death-Reply.","authors":"Darren Tanner, Juan Lavista Ferres, Edwin A Mitchell","doi":"10.1001/jamapediatrics.2024.4713","DOIUrl":"10.1001/jamapediatrics.2024.4713","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":"103-104"},"PeriodicalIF":24.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}