IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-04 DOI: 10.1542/peds.2024-066758

Nikolaos Gkiourtzis, Anastasia Stoimeni, Agni Glava, Sofia Chantavaridou, Panagiota Michou, Konstantinos Cheirakis, Alexander D Lalayiannis, Sally A Hulton, Despoina Tramma

{"title":"Prophylaxis Options in Children With a History of Recurrent Urinary Tract Infections: A Systematic Review.","authors":"Nikolaos Gkiourtzis, Anastasia Stoimeni, Agni Glava, Sofia Chantavaridou, Panagiota Michou, Konstantinos Cheirakis, Alexander D Lalayiannis, Sally A Hulton, Despoina Tramma","doi":"10.1542/peds.2024-066758","DOIUrl":"https://doi.org/10.1542/peds.2024-066758","url":null,"abstract":"Context: The prevention of urinary tract infection recurrence (UTI) in children has been a challenge yet to be solved. Current practice in children with recurrent UTI (RUTI) suggests that antibiotic prophylaxis may prevent further episodes of UTI and future complications.Objective: To conduct a systematic review and meta-analysis of randomized controlled trials comparing prophylaxis options for the prevention of UTI and kidney scarring in children with a history of RUTI.Data sources: We conducted a systematic literature search through major electronic databases (PubMed/Medline, Scopus and Cochrane Library) up to November 26th, 2023. Mean difference and SD were used for continuous outcomes and odds ratio for dichotomous outcomes.Study selection: Our meta-analysis included 3335 participants from 23 studies.Data extraction: The primary outcome was the effect of the different prophylaxis options on the incidence of symptomatic UTI in children with RUTI during prophylactic treatment.Results: Cranberry products and nitrofurantoin lead to lower odds of symptomatic UTI episodes during prophylaxis compared with the control group and control, trimethoprim-sulfamethoxazole, or trimethoprim groups accordingly. Nitrofurantoin may be the best option for UTI incidence reduction compared with all available documented interventions.Limitations: No prophylaxis option has been shown to reduce kidney scarring.Conclusions: Nitrofurantoin and cranberry products may decrease the incidence of symptomatic UTI episodes in pediatric patients with a history of RUTI. Future randomized control trials studying nonantibiotic prophylaxis options focusing on children with UTI recurrence and the risk for kidney scarring are needed to draw further conclusions.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":null,"pages":null},"PeriodicalIF":6.2,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569368","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}

引用次数: 0

Recurrent Urinary Tract Infection Prevention: Progress and Challenges. 预防复发性尿路感染：进展与挑战。

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-04 DOI: 10.1542/peds.2024-068728

Joshua R Watson, Jason G Newland

引用次数: 0

How Can We Accelerate the Use of Zinc for the Treatment of Diarrhea in Low- and Middle-Income Countries? 如何在中低收入国家加快使用锌治疗腹泻？

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-01 DOI: 10.1542/peds.2024-068146

Zulfiqar A Bhutta, Sajid B Soofi

引用次数: 0

Improving Time to Goals of Care Discussions in Invasively Ventilated Preterm Infants. 缩短有创通气早产儿的护理目标讨论时间。

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-01 DOI: 10.1542/peds.2024-066585

Samuel J Gentle, Charli Cohen, Waldemar A Carlo, Lindy Winter, Madhura Hallman

{"title":"Improving Time to Goals of Care Discussions in Invasively Ventilated Preterm Infants.","authors":"Samuel J Gentle, Charli Cohen, Waldemar A Carlo, Lindy Winter, Madhura Hallman","doi":"10.1542/peds.2024-066585","DOIUrl":"10.1542/peds.2024-066585","url":null,"abstract":"Background and objectives: The challenge of identifying preterm infants with bronchopulmonary dysplasia (BPD) that need tracheostomy placement may delay goals of care (GOC) discussions. By identifying infants with a low probability of ventilation liberation, timely GOC discussions may reduce the time to tracheostomy. Our SMART aim was to reduce the postmenstrual age (PMA) of GOC discussions by 20% in infants with BPD and prolonged invasive ventilatory requirement by October 2020.Methods: Our group conducted a quality improvement initiative at the University of Alabama at Birmingham. Infants were included if born at <32 weeks' gestation and exposed to invasive ventilation for ≥2 weeks beyond 36 weeks' PMA. Interventions included (1) consensus of BPD infants at risk for tracheostomy dependence, (2) monthly multidisciplinary tracheostomy meetings, and (3) development and utilization of tracheostomy educational content for families. Statistical process control charts were used for all analyses.Results: A total of 79 infants were included in analyses, of which 44 infants either received a tracheostomy or died. From X-mR control chart analysis, there was special cause variation in the time to GOC discussions, which decreased from 62 to 51 weeks' PMA related to monthly multidisciplinary conferences. The average PMA at tracheostomy decreased from 80 weeks to 63 weeks with no change in the frequency of tracheostomy placement or discordant GOC discussions in which infants survived to hospital discharge without a tracheostomy.Conclusions: In infants with ventilator-dependent BPD, standardization of GOC discussions reduced the PMA of GOC discussions and tracheostomy.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":null,"pages":null},"PeriodicalIF":6.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Safety of a 4-Dose 20-Valent Pneumococcal Conjugate Vaccine Series in Infants: A Randomized Trial. 婴儿接种 4 剂 20 价肺炎球菌结合疫苗系列的安全性：随机试验

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-01 DOI: 10.1542/peds.2023-065218

Gabriella Hajdu, Teena Hughes, G Laïssa Ouedraogo, Laurence Flint, Mariano Young, Vrunda Parikh, Dung-Yang Lee, Yahong Peng, William C Gruber, Daniel A Scott, Wendy Watson

{"title":"Safety of a 4-Dose 20-Valent Pneumococcal Conjugate Vaccine Series in Infants: A Randomized Trial.","authors":"Gabriella Hajdu, Teena Hughes, G Laïssa Ouedraogo, Laurence Flint, Mariano Young, Vrunda Parikh, Dung-Yang Lee, Yahong Peng, William C Gruber, Daniel A Scott, Wendy Watson","doi":"10.1542/peds.2023-065218","DOIUrl":"10.1542/peds.2023-065218","url":null,"abstract":"Background and objectives: The 20-valent pneumococcal conjugate vaccine (PCV20) was developed to expand protection for pneumococcal disease. It contains all 13-valent pneumococcal conjugate vaccine (PCV13) components plus conjugates for 7 additional serotypes. Our primary objective with this study was to evaluate PCV20 tolerability and safety.Methods: In this phase 3, multi-country, double-blind study, healthy infants born at ≥34 weeks' gestation were randomly assigned 2:1 to receive PCV20 or PCV13 at 2, 4, 6, and 12 to 15 months of age. Safety assessments included local reactions and systemic events within 7 days after each vaccination, adverse events (AEs) from dose 1 to 1 month after dose 3 and from dose 4 to 1 month after dose 4, and serious AEs and newly diagnosed chronic medical conditions from dose 1 through 6 months after the last dose.Results: Participants received PCV20 (N = 1000) or PCV13 (N = 504); 91.7% received all 4 doses. The frequencies of local reactions and systemic events were generally similar in PCV20 and PCV13 groups, with most reported as mild or moderate. The most common local reaction was injection site pain (PCV20, 24.7% to 40.5%; PCV13, 26.8% to 42.0%); irritability was the most common systemic event (PCV20, 54.8% to 68.2%; PCV13, 54.7% to 68.5%). AE frequencies were similar in both groups. No serious AEs were related to study vaccines. Few newly diagnosed chronic medical conditions were reported (2.8% in both groups). PCV20 was safe across multiple countries, in late preterm infants, and when administered with other vaccines.Conclusions: A 4-dose series of PCV20 had a tolerability and safety profile similar to that of PCV13.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":null,"pages":null},"PeriodicalIF":6.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372526","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}

引用次数: 0

Early Childhood Concussion. 儿童早期脑震荡

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-01 DOI: 10.1542/peds.2023-065484

Miriam H Beauchamp, Vicki Anderson, Linda Ewing-Cobbs, Juliet Haarbauer-Krupa, Audrey McKinlay, Shari L Wade, Stacy J Suskauer

引用次数: 0

Pediatric Obesity Pharmacotherapy: State of the Science, Research Gaps, and Opportunities. 儿科肥胖症药物疗法：科学现状、研究差距和机遇。

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-01 DOI: 10.1542/peds.2024-067858

Sarah C Armstrong, Ihuoma Eneli, Stavroula K Osganian, Brooke E Wagner, Stephanie W Waldrop, Aaron S Kelly

{"title":"Pediatric Obesity Pharmacotherapy: State of the Science, Research Gaps, and Opportunities.","authors":"Sarah C Armstrong, Ihuoma Eneli, Stavroula K Osganian, Brooke E Wagner, Stephanie W Waldrop, Aaron S Kelly","doi":"10.1542/peds.2024-067858","DOIUrl":"10.1542/peds.2024-067858","url":null,"abstract":"Pediatric obesity is a major public health problem, affecting nearly 20% of children and adolescents living in the United States. In 2023, the American Academy of Pediatrics released its first clinical practice guideline for the evaluation and management of child and adolescent obesity and recommended integrating health behavior and lifestyle interventions with pharmacological treatment when medically indicated. However, there is a limited evidence base to guide antiobesity medication treatment decisions in clinical practice and limited data on long-term safety during this critical period of growth and development in youth. Thus, in November of 2023, the National Institute of Diabetes and Digestive and Kidney Diseases sponsored a workshop to identify knowledge gaps and opportunities for research on the use of pharmacotherapy for obesity in children and adolescents. Leading scientific and clinical experts in obesity pathophysiology and treatment, pharmacotherapy, clinical trial design, and health equity and disparities, among others, identified gaps in clinical trial design, guidance for clinical use of medications in children and adolescents, additional treatment outcomes beyond body fat or weight, and improvement in care delivery. Adolescent patients and caregivers with lived experience of obesity and weight management were also invited to participate in a panel discussion, providing personal perspectives on living with obesity, clinical care considerations, and research needs. This article summarizes the workshop proceedings on the state of the science and identifies gaps and opportunities for future research to inform optimal and equitable medical management of children and adolescents with obesity.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":null,"pages":null},"PeriodicalIF":6.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Characteristics of Fatalities Among Sexual- and Gender-Diverse Youth in the United States: 2015-2020. 美国不同性取向和性别青少年的死亡特点：2015-2020.

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-01 DOI: 10.1542/peds.2024-067043P

Bridget Duffy, O Madison Nurre, Saroj Bista, Fiona O'Malley, Nichole L Michaels

{"title":"Characteristics of Fatalities Among Sexual- and Gender-Diverse Youth in the United States: 2015-2020.","authors":"Bridget Duffy, O Madison Nurre, Saroj Bista, Fiona O'Malley, Nichole L Michaels","doi":"10.1542/peds.2024-067043P","DOIUrl":"https://doi.org/10.1542/peds.2024-067043P","url":null,"abstract":"Objectives: Sexual- and gender-diverse youth face unique stressors that negatively impact their health. The objective of this study was to use National Fatality Review-Case Reporting System data to epidemiologically describe fatalities among identified sexual- and gender-diverse youth to inform future prevention efforts.Methods: We used 2015 to 2020 data from the National Fatality Review-Case Reporting System to identify deaths among sexual- and gender-diverse youth and compare their characteristics to a matched sample of youth from these same data who were not known to be sexual- and gender-diverse. Demographic, injury, death, history, and life stressor characteristics were analyzed using descriptive statistics.Results: During the study period, 176 fatalities were identified among sexual- and gender-diverse youth. Decedents' mean age was 15.3 years. A greater proportion of deaths was attributed to suicide among sexual- and gender-diverse youth (81%) compared with nonsexual- and gender-diverse youth (54%). Receiving prior (69%) and/or current (49%) mental health services was more common among sexual- and gender-diverse youth, compared with nonsexual- and gender-diverse youth (50% and 31%, respectively). Sexual- and gender-diverse youth were significantly more likely to experience problems in school or be victims of bullying, compared with nonsexual- and gender-diverse youth (63% versus 47% and 28% versus 15%, respectively).Conclusions: Suicide was the most common manner of death for sexual- and gender-diverse youth, despite many decedents receiving current or prior mental health services. These findings indicate the need to improve and diversify interventions to prevent these deaths.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":null,"pages":null},"PeriodicalIF":6.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558474","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}

引用次数: 0

National Fatality Review Case Reporting System: Twenty Years of Data Collection. 全国死亡病例审查报告系统：二十年的数据收集。

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-01 DOI: 10.1542/peds.2024-067043C

Abigael Collier, Heather Dykstra, Esther Shaw, Rosemary Fournier, Patricia Schnitzer

{"title":"National Fatality Review Case Reporting System: Twenty Years of Data Collection.","authors":"Abigael Collier, Heather Dykstra, Esther Shaw, Rosemary Fournier, Patricia Schnitzer","doi":"10.1542/peds.2024-067043C","DOIUrl":"https://doi.org/10.1542/peds.2024-067043C","url":null,"abstract":"The National Fatality Review Case Reporting System (NFR-CRS) is a web-based data collection tool for child death review and fetal and infant mortality review teams. The NFR-CRS captures information from the multidisciplinary review, including the social and community risk factors that may have impacted the death. The NFR-CRS is a nimble data system that has evolved throughout the past 20 years. The most recent enhancements include a life stressors section focused on collecting contextual information such as racism and poverty, revised cause of death sections to better align data collected with risk factors identified in the research, and enhanced data visualizations. The NFR-CRS has improved data quality since the launch of a data quality initiative in 2015. As a result of the data quality initiative, the completeness, consistency, accuracy, and timeliness of the NFR-CRS data have improved. Limitations for the NFR-CRS include the fact that data entered are not population-based, data fields have evolved over time, and there are high percentages of missing and unknown data. Despite its limitations, the NFR-CRS remains a valuable research tool, especially when paired with other data sources.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":null,"pages":null},"PeriodicalIF":6.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558384","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}

引用次数: 0

Partnering With Parents to Change Measurement and Reporting of Preterm Birth Outcomes. 与父母合作，改变早产结果的测量和报告。

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-01 DOI: 10.1542/peds.2024-067093

Rebecca Pearce, Anne Synnes, Mei Mei Lam, Lindsay L Richter, Fabiana Bacchini, Melissa Jones, Thuy Mai Luu, Annie Janvier

引用次数: 0

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