M Florencia Ricci, Gilles R Detillieux, Sepideh Yousefiasl, Lonnie Zwaigenbaum, Stefanie Narvey, Marina Yogendran, Marcelo L Urquia
{"title":"Autism and immigration background, insights from a population-based study.","authors":"M Florencia Ricci, Gilles R Detillieux, Sepideh Yousefiasl, Lonnie Zwaigenbaum, Stefanie Narvey, Marina Yogendran, Marcelo L Urquia","doi":"10.1093/pch/pxaf115","DOIUrl":"10.1093/pch/pxaf115","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the relationship between immigration and autism in Manitoba, Canada, using population-based data.</p><p><strong>Methods: </strong>We linked Manitoba's Rehabilitation Centre for Children clinical registry (May 2016-December 2022), the province's primary and only publicly funded autism evaluation site for children ≤6 years, with an official immigration registry. We estimated incidence of autism and adjusted relative risks (aRR) with 95% confidence intervals (CI) across subgroups defined by child and parent immigration status.</p><p><strong>Results: </strong>A total of 217,811 children aged 18 months to 6 years resided in Manitoba during the study period and met inclusion criteria. Among 2408 children diagnosed with autism, 1136 (47%) had at least one immigrant parent. Compared with Canadian-born children of nonimmigrant parents, autism risk was highest among Canadian-born children of at least one immigrant parent (aRR: 2.29; 95% CI: 2.09-2.51), followed by immigrant children of at least one immigrant parent (aRR: 1.72; 95% CI: 1.42-2.09). Maternal length of stay in Canada and refugee status was not associated with autism risk. In secondary analysis examining parental contribution to likelihood of autism, compared with Canadian children of two nonimmigrant parents, likelihood of autism diagnosis was higher among children in all parental immigration categories, but highest when both the mother and the father were immigrants (aRR: 3.08, 95% CI: 2.62-3.62).</p><p><strong>Conclusion: </strong>Children of immigrant families in Manitoba had higher rates of autism. Additional studies are warranted to assess whether similar results occur in other Canadian jurisdictions, and to investigate possible underlying factors behind this association.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 2","pages":"120-127"},"PeriodicalIF":2.5,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444630","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":"Correction to: Trends of prenatal opioid utilization and neonatal abstinence syndrome in Manitoba, Canada: A 26-year population-based cohort study.","authors":"","doi":"10.1093/pch/pxaf117","DOIUrl":"https://doi.org/10.1093/pch/pxaf117","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/pch/pxaf028.].</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 1","pages":"73"},"PeriodicalIF":2.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12861525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146106704","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":"Therapeutic dilemma of PPI use in infants-no longer a dilemma.","authors":"Simran Aggarwal, Michael Rieder","doi":"10.1093/pch/pxaf111","DOIUrl":"10.1093/pch/pxaf111","url":null,"abstract":"<p><p>While proton pump inhibitors (PPIs) are widely recognized for their effectiveness in treating gastroesophageal reflux disease in older children and adults, their use in infants is controversial due to the paucity of well-controlled studies demonstrating clear benefits. Furthermore, concerns about potential adverse effects, such as increased risks of gastrointestinal and respiratory infections, nutrient malabsorption and alterations in gut microbiota, complicate the decision-making process for health care providers and care givers. The current guidelines emphasize nonpharmacologic management for infantile reflux and recommend PPIs for very specific indications. Despite this, PPIs continue to be widely prescribed to infants.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 1","pages":"4-7"},"PeriodicalIF":2.0,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12861528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146106648","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}
Felicia Paluck, Anjelica Guytingco, Emma Carscadden, Olivia Ostrow
{"title":"Non-invasive urinary tract infection screening for young infants: A high-value care initiative.","authors":"Felicia Paluck, Anjelica Guytingco, Emma Carscadden, Olivia Ostrow","doi":"10.1093/pch/pxaf092","DOIUrl":"https://doi.org/10.1093/pch/pxaf092","url":null,"abstract":"<p><p>Our aim was to safely decrease unnecessary invasive urinary catheterizations in infants 90 days to <6 months of age by 50% over 24 months in our emergency department without unintended consequences. A multi-professional study team was established, and key stakeholders engaged. Using the Model for Improvement, we implemented a modified 2-step urine bag urinary tract infection (UTI) screening pathway along with reminders and education as our main change ideas. The mean catheterization rate decreased from a baseline of 62.5% to 43.9% during the intervention period, demonstrating special cause variation. Urine cultures also decreased from a mean of 64.7% to 47.3% with special cause variation. There was no increase in length of stay or return visits. There was one potential missed UTI (1/843 patients). Overall, a 2-step non-invasive urine bag UTI screening pathway can be successfully and safely used in the emergency department for young infants aged 90 days and older to improve resource allocation.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 1","pages":"8-14"},"PeriodicalIF":2.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12861536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146106684","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":"Trends in self-harm visits to the emergency department among children and youth before and during the COVID-19 pandemic in Alberta: An interrupted time series analysis.","authors":"Rebecca Barry, Michele Dyson, Matthew Hubert, Halley Silversides, Shelly Vik, Katherine Rittenbach","doi":"10.1093/pch/pxaf087","DOIUrl":"10.1093/pch/pxaf087","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to describe and compare the rate of self-harm visits to the emergency department (ED) among children and youth in Alberta, before and after the COVID-19 pandemic.</p><p><strong>Methods: </strong>Data from 2010 to 2022 were obtained from administrative databases held at Alberta Health Services, which capture all ED visits across Alberta. An interrupted time series was implemented using autoregressive moving average models.</p><p><strong>Results: </strong>Findings indicate a step decrease in self-harm visits at pandemic onset (-2.94 patients per 10,000; <i>P</i> = 0.008). However, the rate of increase in self-harm visits remained consistent with the prepandemic rate of visits (slope change: 0.047 per 10,000, <i>P</i> = 0.24). There were also significant step changes found among males and females, several age subsets and among rural and urban subsets, but there were no significant slope changes among any subgroups.</p><p><strong>Conclusion: </strong>Overall, findings indicate that the rate of self-harm visits following the onset of the pandemic did not differ from that which would be expected based on the upward trend in the 10 years before the pandemic, and this finding was consistent when stratifying by sex, age, and rurality. There was a significant reduction in self-harm visits at the onset of the COVID-19 pandemic.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 1","pages":"50-55"},"PeriodicalIF":2.0,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12861531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146106661","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":"Vomiting, hypotonia and failure to thrive in a 12-month-old female.","authors":"Beth E MacDonald, Philip D Acott, Emma Burns","doi":"10.1093/pch/pxaf094","DOIUrl":"10.1093/pch/pxaf094","url":null,"abstract":"","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"30 8","pages":"660-661"},"PeriodicalIF":2.0,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12718001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805161","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":"Appealing abstracts: ChatGPT or outside advice? Letter to the editor: Will ChatGPT-4 improve the quality of medical abstracts?","authors":"Shigeki Matsubara","doi":"10.1093/pch/pxaf095","DOIUrl":"10.1093/pch/pxaf095","url":null,"abstract":"","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"30 8","pages":"662-663"},"PeriodicalIF":2.0,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12718067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805041","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}
Jacob Joel Kirsh Carson, Natalie Urbach, Kirk Leifso
{"title":"Otoscopy-based diagnosis of paediatric acute otitis media: An evaluation of guideline adherence.","authors":"Jacob Joel Kirsh Carson, Natalie Urbach, Kirk Leifso","doi":"10.1093/pch/pxaf102","DOIUrl":"https://doi.org/10.1093/pch/pxaf102","url":null,"abstract":"<p><strong>Objectives: </strong>Over diagnosis of acute otitis media (AOM) may lead to unnecessary antibiotic prescriptions and overuse of health care resources. To date, no study has determined which otoscopy findings frontline physicians use to diagnose AOM, and whether lack of adherence to otoscopy guidelines contributes to over diagnosis.</p><p><strong>Methods: </strong>In this single-centre multisite retrospective chart review, we determined adherence to Canadian Paediatric Society (CPS) AOM diagnosis guidelines based on documented otoscopy findings in patient charts.</p><p><strong>Results: </strong>Of 192 cases of nonperforated AOM with a documented physical examination, only 124 (64.6%) had otoscopy findings of both middle ear effusion and inflammation, consistent with CPS criteria. Fifty-eight cases (30.2%) had documented middle ear inflammation without effusion. The most reported otoscopy findings were a red and bulging tympanic membrane (TM) in 81 (42.2%) cases. The presence (<i>n</i> = 104) or absence (<i>n</i> = 4) of bulging was only documented in 108 (56.2%) cases. The odds ratio for cases meeting diagnostic criteria was significantly higher for those seen by paediatricians compared with general providers (OR 2.82, 95% CI: [1.44-5.53], <i>P</i> < 0.01), for those assessed by residents or medical students compared with staff physicians (OR 2.04, 95% CI [1.05-3.98], <i>P</i> = 0.03), and those of older age (OR 1.14, 95% CI [1.00-1.29], <i>P</i> = 0.044).</p><p><strong>Conclusions: </strong>This study highlights that AOM over diagnosis may be related to lack of adherence to diagnosis guidelines. Simplification of guidelines, such as more explicitly requiring a bulging TM, may improve diagnostic accuracy and reduce health care resource overuse for this common paediatric condition.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 2","pages":"98-103"},"PeriodicalIF":2.0,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444309","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":"Insights into pediatric epilepsy and systemic autoimmune disorders: A study using the national inpatient database.","authors":"Reem Alyoubi, Ahmed Abu-Zaid","doi":"10.1093/pch/pxaf097","DOIUrl":"https://doi.org/10.1093/pch/pxaf097","url":null,"abstract":"<p><strong>Background: </strong>Epilepsy and systemic autoimmune disorders (SADs) are significant in pediatric populations, yet most research focuses on adults.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of the National Inpatient Sample (2016-2020) for pediatric patients (≤18 years) with SADs. Patients with and without epilepsy were compared by demographics and clinical factors. Multivariate logistic regression assessed associations. To account for multiple testing, a Bonferroni correction set the adjusted significance threshold at <i>α</i> = 0.002.</p><p><strong>Results: </strong>Of 4,816,131 pediatric patients, 5371 had both SADs and epilepsy. Multivariate analysis confirmed a strong association between SADs and epilepsy (OR: 2.79, 95% CI: 2.71-2.87). Addison's disease (OR: 10.09, 95% CI: 8.12-12.55), hypothyroidism (OR: 9.14, 95% CI: 8.8-9.48), vitiligo (OR: 3.29, 95% CI: 2.26-4.87), and autoimmune thyroiditis (OR: 3.25, 95% CI: 2.8-3.77) were the strongest independent predictors (<i>P</i> < 0.0001).</p><p><strong>Conclusion: </strong>Pediatric epilepsy is significantly associated with several SADs, highlighting the need for multidisciplinary approaches to manage these conditions.</p>","PeriodicalId":19730,"journal":{"name":"Paediatrics & child health","volume":"31 1","pages":"56-62"},"PeriodicalIF":2.0,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12861535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146106717","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}