Pediatrics最新文献

{"title":"Effects of Semaglutide on Weight and Insulin Requirements in Two Adolescents With Type 1 Diabetes.","authors":"Christine Rode Schwarz, Tina Vilsbøll, Malene Ø Aistrup, Julie T Kloppenborg","doi":"10.1542/peds.2025-074286","DOIUrl":"https://doi.org/10.1542/peds.2025-074286","url":null,"abstract":"<p><p>We present 2 case reports of the benefits of the subcutaneous once-weekly glucagon-like peptide 1 receptor agonist (GLP-1RA) therapy semaglutide in adolescents with type 1 diabetes (T1D) complicated by obesity. Two female individuals (17 and 12 years old) with T1D who have automated and continuous insulin delivery systems presented with marked weight gain, increasing insulin requirement, and suboptimal glycemic control. We added GLP-1RA to standard insulin pump therapy and revisited education related to healthy lifestyle. Both adolescents achieved notable improvements in glycemic control, weight, and insulin requirement after 12 months of treatment without any adverse events. These cases suggest that adjunctive GLP-1RA therapy may improve metabolic control and body weight management in adolescent T1D with obesity. Larger studies are needed to clarify optimal dosing and safety, including long-term effects on body composition and growth.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving the Delivery of Quality Evidence-Based Inpatient Asthma Care.","authors":"Eleanor E Young, Daniela Bullard-Elias, Skylar Faul, Jessica Luong, Abbey Scott, Andrew F Beck, Laura Brower, Jennifer D Treasure","doi":"10.1542/peds.2025-073834","DOIUrl":"https://doi.org/10.1542/peds.2025-073834","url":null,"abstract":"<p><strong>Objective: </strong>Evidence-based care guidelines and clinical pathways are central to quality, equitable, and standardized pediatric asthma care. We sought to improve delivery of optimal guideline-concordant asthma care, defined as documentation of (1) medical and social-environmental risk assessment, (2) a maintenance medication plan, and (3) accurate asthma action plan at discharge. Specifically, we sought to increase the proportion of hospital medicine patients receiving all 3 components from 15% to 80% over 12 months.</p><p><strong>Methods: </strong>Our multidisciplinary team defined and operationalized optimal inpatient asthma care using the chronic care model, published literature, and local expert input. Interventions focused on guideline-concordant clinical decision support and educational tools aligned to recently updated Global Initiative for Asthma guidelines, enhanced interdisciplinary communication, and redefined inpatient care processes. Process measures included bundled all-or-none completion of the 3 optimal care components. Outcome measures included 30- and 90-day asthma-related readmissions, length of stay, and rates of inhaled corticosteroid-containing prescription regimens at hospital discharge.</p><p><strong>Results: </strong>Over 12 months of interventions, receipt of optimal asthma care improved from 15% to 69%. Independently, there were notable increases in completion of all 3 components of optimal care. For example, medication maintenance plans, as defined by rates of inhaled corticosteroid prescriptions at hospital discharge, notably increased in alignment with asthma guidelines, from 71% to 80% (P = .002). We also noted a reduction in length of stay and 90-day readmission rates.</p><p><strong>Conclusions: </strong>Multidisciplinary interventions targeting clinical decision support and interdisciplinary communication were associated with improved receipt of guideline-concordant care and reduced readmissions.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malaria in Children at 9 US Hospitals: 2016-2023.","authors":"Sesh Alexander Sundararaman, Brianne Roper, Amy K F Davis, Karen L Hanze Villavicencio, Jonathan A Mayhew, Michelle L Wang, Nina L Tang, Vijaya L Soma, Ziyi Wang, Margaret E Feeney, Indi Trehan, Jill E Weatherhead, Chandy C John, Jeffrey S Gerber, Audrey R Odom John","doi":"10.1542/peds.2025-073556","DOIUrl":"10.1542/peds.2025-073556","url":null,"abstract":"<p><p></p><p><strong>Objectives: </strong>This study set out to describe imported pediatric malaria in the United States over an 8-year period, including patient demographics, clinical outcomes, and risk factors for severe disease.</p><p><strong>Methods: </strong>A retrospective descriptive study of pediatric patients treated for malaria at 9 hospitals in the United States from 2016 to 2023 was conducted to analyze patient demographics, clinical outcomes, and risk factors for severe malaria.</p><p><strong>Results: </strong>A total of 171 children were treated across the 9 US hospitals included in this study from 2016 to 2023. Most patients had traveled to West Africa to visit friends and relatives. Fever was the most common symptom recorded (90%), and most reported at least 1 abdominal symptom (66%). Thirty-two percent of patients were diagnosed with severe malaria. No deaths occurred. Delayed diagnoses were common (26%), occurred at similar rates across all hospitals in the study, and were a risk factor for severe malaria.</p><p><strong>Conclusions: </strong>Delayed diagnoses of travel-acquired malaria were common for pediatric patients presenting to hospitals in the United States and are associated with higher risk for severe malaria, which is associated with longer hospitalizations and increased morbidity. Chemoprophylaxis against travel-acquired malaria and prompt diagnosis of imported cases are crucial to improving patient outcomes.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State Paid Sick Leave Mandates and Receipt of Pediatric Preventive Dental Care.","authors":"Alexandra Skinner, Johanna Catherine Maclean, Bradley D Stein, Ashley M Kranz","doi":"10.1542/peds.2025-074276","DOIUrl":"https://doi.org/10.1542/peds.2025-074276","url":null,"abstract":"<p><p></p><p><strong>Background and objectives: </strong>Biannual preventive dental visits are recommended to promote good oral health and identify problems, yet children in many families do not receive this care due to time-related barriers. Paid sick leave mandates have the potential to relieve parental time constraints and facilitate scheduling and attending pediatric dental visits; thus, we sought to evaluate the effects of state paid sick leave mandates on children's receipt of preventive dental care.</p><p><strong>Methods: </strong>Using 2016 to 2023 National Survey of Children's Health data and a difference-in-differences approach, we compared trends in children's receipt of preventive dental care in states that did and did not implement paid sick leave mandates.</p><p><strong>Results: </strong>Pre-implementation of paid sick leave mandates, children residing in states that later implemented these policies were more likely to have received preventive dental care, to be non-Hispanic white, to have private health insurance, and to have parents with more than a high school education, relative to children residing in states that never implemented paid sick leave mandates. State paid sick leave mandates were associated with a 3.2% relative increase (95% CI: 0.2%, 6.2%) in rates of children receiving preventive dental care, controlling for time-varying demographic and policy characteristics, with state and year fixed effects.</p><p><strong>Conclusions: </strong>State-paid sick leave mandates may alleviate competing parental work and caregiving responsibilities and provide parents with additional time and flexibility to obtain dental care for their children.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Bayley-4 Versus the Bayley-III in Very Preterm Children at 24 Months' Corrected Age.","authors":"Elizabeth M Hurrion, Sol Libesman, Samudragupta Bora, Peter S Cunningham, Paul A Dawson, Peter J Anderson","doi":"10.1542/peds.2025-072903","DOIUrl":"https://doi.org/10.1542/peds.2025-072903","url":null,"abstract":"<p><strong>Objectives: </strong>The Bayley is widely used for developmental assessment of young children. Reports suggest that Bayley-III overestimates scores and underidentifies developmental delay. Hypothesis: Using preterm cohort data, Bayley-4 scores will be lower than Bayley-III, with higher rates of developmental delay.</p><p><strong>Methods: </strong>Data are from the SuPreme Study, a prospective observational cohort of 1601 very preterm infants born 2013-2020. Follow-up included assessment at 24 months corrected age using the Bayley edition in routine use at the time, Bayley-III or Bayley-4 (Bayley-4A&NZ version).</p><p><strong>Results: </strong>Of 1509 surviving SuPreme study participants, 96.6% were followed up. Bayley scores were obtained on a subgroup of 1034 (68.5%): 525 Bayley-III and 509 Bayley-4. Baseline characteristics and corrected age at assessment were similar. Adjusted mean difference estimates between standard scores on Bayley-4A&NZ vs Bayley-III were cognitive -10.3 (95% CI [-11.9 to -8.8]; P < .001), language -5.9 (95% CI [-7.6 to -4.1]; P < .001), motor -3.7 (95% CI [-5.2 to -2.2]; P < .001. Cognitive scores more than 2 standard deviations below the mean occurred in 12.8% of Bayley-4A&NZ group vs 4% of the Bayley-III group.</p><p><strong>Conclusions: </strong>Bayley-4A&NZ standard scores are lower than Bayley-III scores. Adjusted mean differences between scores are large. The findings apply across a broad range of developmental functioning. The clinical corollary is a higher proportion of children are identified with developmental delay using Bayley-4, particularly moderate/severe cognitive delay-adjusted relative risk ratio 4.0. More children will meet access criteria for early support services. Further implications are that research/audit data using different editions cannot be directly compared. Studies of other Edition-4 versions are warranted.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AAP's Transition to GRADE for Clinical Practice Guidelines.","authors":"Corinna J Rea, Sandra P Spencer","doi":"10.1542/peds.2026-076208","DOIUrl":"https://doi.org/10.1542/peds.2026-076208","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-Year Outcomes in Children Born With a Congenital Pulmonary Malformation.","authors":"Marie Blanquer, Isabelle Monier, Naziha Khen-Dunlop, Olivier Abbo, Arnaud Bonnard, Laure Choupeaux, Virginie Fouquet, Edouard Habomimana, Erik Hervieux, Christian Piolat, Diana Potop, Rony Sfeir, Babak Khoshnood, Nathalie Lelong, Frédéric Hameury, Christophe Delacourt","doi":"10.1542/peds.2025-074173","DOIUrl":"https://doi.org/10.1542/peds.2025-074173","url":null,"abstract":"<p><strong>Background: </strong>Families and clinicians need more information about complications associated with congenital pulmonary malformations (CPMs) to engage in shared decision-making about surgery for asymptomatic children. The study's aim was to prospectively describe symptoms in children with a CPM and to identify markers associated with surgical removal because of symptoms.</p><p><strong>Methods: </strong>MALFPULM is a prospective population-based nationally representative cohort including pregnant women whose fetus had a CPM. Events occurring between birth and 2 years of age were compared between children who were not operated on, those with elective surgery (reference group), and those operated on because of symptoms.</p><p><strong>Results: </strong>Of the 322 children with complete clinical follow-up at 2 years, 48 (15%) were operated on because of symptoms. When compared with children with elective surgery, they had a higher prenatal maximal CPM Volume Ratio (CVRmax) (P < .001) as well as a higher rate of neonatal respiratory distress (P < .001), eating difficulties (P = .002), pneumothorax (P < .05), or hospitalization for respiratory complication (P < .001). CVRmax greater than 1 cm2 was observed in 44% of children operated on because of symptoms, compared with 14% in other subgroups (P < .001). Only 3% of the children had an infection of the CPM, with no significant influence of the cystic nature of the CPM. Symptom frequency did not differ significantly between children who were not operated on and children with elective surgery, with recurrent cough and wheezing being the most frequent symptoms.</p><p><strong>Conclusion: </strong>Symptoms leading to surgical removal were observed in only 15% of children with CPM, with CVRmax greater than 1 cm2 being a significant risk factor. Elective surgery did not modify the frequency of less severe symptoms.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to Advance Practice Nursing in Neonatology: Clinical Report.","authors":"","doi":"10.1542/peds.2026-077289","DOIUrl":"https://doi.org/10.1542/peds.2026-077289","url":null,"abstract":"<p><p>Lisa M. Grisham, Jay P. Goldsmith, Ashley M. Lucke, Sheila M. Gephart, AAP Committee on Fetus and Newborn; Advanced Practice Nursing in Neonatology: Clinical Report. Pediatrics September 2025; 156 (3): e2025073170. 10.1542/peds.2025-073170 This Clinical Report has been edited as follows: (1) removal of the National Association of Neonatal Nurses as a co-author, (2) updated text including the required hours of training for Advanced Practice Registered Nurses (APRNs) consistent with several new references, (3) revisions to remove mention of specific gestational ages, but emphasizing the type/acuity of patients in neonatal care settings that would be appropriately aligned with APRN training and licensure (including removal of the \"Neonatal Setting\" column in Table 2), and (4) updated data in Table 3 related to Practice Authority by State.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simultaneous TFAM and TJP2 Variants in a Child With Cirrhosis and Hepatocellular Carcinoma.","authors":"Jindan Yu, Hong Zhao, Youyou Lou, Youhong Fang, Weizhong Gu, Jie Chen, Jingan Lou","doi":"10.1542/peds.2025-071481","DOIUrl":"https://doi.org/10.1542/peds.2025-071481","url":null,"abstract":"<p><p>Pediatric hepatocellular carcinoma (HCC), a rare and life-threatening malignancy that typically arises de novo, is strongly associated with underlying metabolic or genetic disorders. Its molecular pathogenesis remains poorly understood due to the limited number of well-documented cases. Herein, we present the case of an 11-year, 5-month-old boy who presented with incidentally detected cirrhosis, growth retardation, and severe pruritus. Whole-exome sequencing revealed a novel homozygous variant in the mitochondrial transcription factor A (TFAM) gene (c.197C>A; p.Pro66His) and compound heterozygous variants in the tight junction protein 2 (TJP2) gene (c.142G>C; p.Val48Leu and c.877C>T; p.Arg293Trp), all classified as variants of uncertain significance (VUS). Immunohistochemistry confirmed reduced expression of TFAM and TJP2, while electron microscopy demonstrated abnormal mitochondrial ultrastructure and compromised biliary epithelial integrity, supporting a diagnosis of combined TFAM and TJP2 deficiency. The disease rapidly progressed from moderately to well-differentiated HCC within 15 months. Following laparoscopic tumor resection, the patient successfully underwent orthotopic liver transplantation at 13 years of age, with normal graft function maintained at the 8-month follow-up. This case provides insights for the diagnosis and management of pediatric liver disease involving multiple VUS, suggests a potential novel pathogenic mechanism of HCC, and highlights the possible synergistic effects of multigene variants. Whether combined TFAM and TJP2 deficiencies directly and synergistically accelerate liver disease progression and hepatocarcinogenesis warrants further validation through additional clinical cases and functional studies.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breastfeeding Initiation and the Formula Shortage in the United States: 2022-2024.","authors":"Luis Seoane Estruel, Tatiana Andreyeva","doi":"10.1542/peds.2025-075813","DOIUrl":"https://doi.org/10.1542/peds.2025-075813","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}