Pediatrics最新文献_第10页

Case of Infant With Metabolic Crisis From Lactational Hypoglycin A and Fatty Acid Defect. 母乳低甘氨酸A及脂肪酸缺陷致婴儿代谢危象1例。

IF 8 2区医学

Pediatrics Pub Date : 2026-03-06 DOI: 10.1542/peds.2025-070887

Hung Ho,April Slamowitz,Cyrus E Kuschner,Jessica Gold,Sharon Dial,Kaytlin Krutsch,Joshua Nogar

{"title":"Case of Infant With Metabolic Crisis From Lactational Hypoglycin A and Fatty Acid Defect.","authors":"Hung Ho,April Slamowitz,Cyrus E Kuschner,Jessica Gold,Sharon Dial,Kaytlin Krutsch,Joshua Nogar","doi":"10.1542/peds.2025-070887","DOIUrl":"https://doi.org/10.1542/peds.2025-070887","url":null,"abstract":"Hypoglycin A is a mitochondrial toxin found in unripe soapberry fruits such as ackee. This toxin disrupts fatty acid β-oxidation, leading to severe metabolic derangements. Although toxic exposure through ingestion has been well documented, transfer through human milk is not well characterized. We report a full-term, exclusively breastfed 5-month-old infant, a carrier of medium-chain acyl-CoA dehydrogenase (MCAD) deficiency, who developed profound hypoketotic hypoglycemia, metabolic and respiratory acidosis, and vasoactive-refractory shock 2 days after maternal ingestion of unripe ackee fruit. Despite aggressive management, including fluids, dextrose infusion, levocarnitine, and empirical antibiotics, the infant developed ventricular dysrhythmias and cardiac arrest. He required venoarterial extracorporeal membrane oxygenation (VA-ECMO) for circulatory support. Metabolic evaluation showed impaired β-oxidation on acylcarnitine profile. Hypoglycin A was detected in breast milk, with concentrations decreasing over time following maternal ingestion. Genetic testing confirmed MCAD carrier status with 2 maternally inherited ACADM variants in cis. The patient was decannulated from VA-ECMO on hospital day 4 and discharged with normal neurological function. This case illustrates a \"2-hit\" model of toxicity, in which genetic vulnerability to impaired fatty acid oxidation compounded the effects of a mitochondrial toxin. It represents a rare and clinically significant instance of hypoglycin A toxicity transmitted via human breast milk and includes the use of extracorporeal life support for hypoglycin A-related metabolic collapse in a human. Clinicians must maintain a high index of suspicion for hypoglycin A exposure in critically ill, breastfed infants and proactively counsel lactating individuals to avoid consumption of unripe ackee fruit to prevent potentially fatal outcomes.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"70 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147359279","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

Mindfulness Intervention for Parent Stress and Childhood Obesity Risk: A Randomized Trial. 父母压力和儿童肥胖风险的正念干预：一项随机试验。

IF 8 2区医学

Pediatrics Pub Date : 2026-03-06 DOI: 10.1542/peds.2025-072230

Nia Fogelman,Heather Bernstein,Tara Bautista,Mary Savoye,Tara M Chaplin,Wendy K Silverman,Ania M Jastreboff,Rajita Sinha

{"title":"Mindfulness Intervention for Parent Stress and Childhood Obesity Risk: A Randomized Trial.","authors":"Nia Fogelman,Heather Bernstein,Tara Bautista,Mary Savoye,Tara M Chaplin,Wendy K Silverman,Ania M Jastreboff,Rajita Sinha","doi":"10.1542/peds.2025-072230","DOIUrl":"https://doi.org/10.1542/peds.2025-072230","url":null,"abstract":"OBJECTIVETo assess whether a novel parent stress with nutrition vs nutrition alone intervention decreases early childhood obesity risk.METHODSA prospective, parallel, 12-week randomized controlled trial with parents who were overweight (114 dyads body mass index [BMI]: 34.7 ± 6.6) and their young children (aged 2-5 years) was conducted between November 2018 and July 2022. Parenting Mindfully for Health (PMH+N) was compared with the control (CTL+N) weekly group intervention, each with nutrition and physical activity (N) psychoeducation. Changes in child BMI and parent stress were coprimary outcomes, whereas observed parenting in an established laboratory-based parent-child Toy-Wait Task (TWT) and child food intake were secondary outcomes.RESULTSChild BMI z score significantly increased by 0.41 ([0.13, 0.69], P < .005) in the CTL+N, but PMH+N remained unchanged (0.20 [-0.49, 0.09], P > .17) over the 3-month follow-up, and parent stress decreased (3.17 [-5.19, -1.15] points, P < .003) only in the PMH+N arm. Significant time main effects indicated increased TWT positive parenting (2.82 [1.24, 4.4], P < .001) and reduced unhealthy child food intake (-1.78 [-3.02, -0.54]), driven by the PMH+N arm (P values <.02). Parent stress interacted with PMH+N vs CTL+N intervention to predict lower TWT positive parenting and child healthy food intake in the CTL+N arm (-1.74 [-3.26, -0.22] and -3.41 [-7.25, 0.42], respectively).CONCLUSIONSTargeting parent stress with healthy nutrition is effective in preventing short-term early childhood obesity risk and in improving positive parenting and child healthy food intake. Further assessment of long-term effects of the PMH+N intervention on early childhood risk is warranted. (Clinical Trials Registration: NCT03950453).","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"21 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147359367","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

Michigan's Crusade for Clean Hands: The Modern Health Crusade Revisited. 密歇根清洁双手运动：现代健康运动重访。

IF 8 2区医学

Pediatrics Pub Date : 2026-03-05 DOI: 10.1542/peds.2025-071429

Dillon Prus

引用次数: 0

Power Training Combined With Interval Treadmill Training in Cerebral Palsy: An RCT. 力量训练结合间歇跑步机训练治疗脑瘫：一项随机对照试验。

IF 8 2区医学

Pediatrics Pub Date : 2026-03-05 DOI: 10.1542/peds.2025-074493

Noelle G Moreau,Kristie F Bjornson,Phil Hurvitz,Donald E Mercante

{"title":"Power Training Combined With Interval Treadmill Training in Cerebral Palsy: An RCT.","authors":"Noelle G Moreau,Kristie F Bjornson,Phil Hurvitz,Donald E Mercante","doi":"10.1542/peds.2025-074493","DOIUrl":"https://doi.org/10.1542/peds.2025-074493","url":null,"abstract":"OBJECTIVESDetermine the effect of lower-extremity power training combined with interval treadmill training (PT3) on walking capacity and performance in children with cerebral palsy (CP).METHODSIn this multisite, single-blinded randomized clinical trial, children with spastic, bilateral CP between ages 10 and 17 years were randomized to receive 24 sessions of either PT3 or traditional strength training combined with steady-state treadmill training (STT). Primary outcomes were normalized self-selected and fast gait speed and muscle power. Participants were assessed at baseline, immediate postintervention, 2-month post, and 6-month post.RESULTSOf 43 recruited participants (20 female participants; mean age 13.1 SD 2.2 years for PT3 group; mean age 13.8 SD 2.6 years for STT group), 38 were included in the final analyses. No differences between groups were observed for self-selected speed. PT3 had significantly greater change in fast speed from baseline to 2-month post compared with STT (adjusted mean difference [MD], 0.030; 95% CI, 0.002-0.059; P = .04). Change in muscle power from baseline to immediate post was significantly greater in the PT3 group (MD, 52.01; 95% CI, 5.63-98.39; P = .03). Stride rate intensity increased immediate post after PT3 (MD, 7.95; 95% CI, 0.45-15.95; P = .04).CONCLUSIONSPower training combined with high-intensity interval treadmill training was superior to an equivalent dosage of traditional strength training combined with steady-state treadmill training for improving muscle power immediate post-training and fast gait speed 2-month post-training. Increases in stride rate intensity after PT3 were not maintained at follow-up time points.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"403 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147350607","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

Generative Artificial Intelligence: Implications for Families and Pediatricians. 生成式人工智能：对家庭和儿科医生的影响。

IF 8 2区医学

Pediatrics Pub Date : 2026-03-04 DOI: 10.1542/peds.2025-074912

Robert W Grundmeier,Alexander G Fiks,Brian P Jenssen,Stephon N Proctor,Daria F Ferro,Kevin B Johnson,

引用次数: 0

Tuberculosis Disease and Infection in US-Bound International Adoptees: 2016 to 2023. 2016年至2023年赴美国际被收养者的结核病和感染

IF 8 2区医学

Pediatrics Pub Date : 2026-03-04 DOI: 10.1542/peds.2025-073442

Yecai Liu,Christina R Phares,Pamela Logan,Michelle S Weinberg,Sean Toney,Drew L Posey,Elizabeth Soda

{"title":"Tuberculosis Disease and Infection in US-Bound International Adoptees: 2016 to 2023.","authors":"Yecai Liu,Christina R Phares,Pamela Logan,Michelle S Weinberg,Sean Toney,Drew L Posey,Elizabeth Soda","doi":"10.1542/peds.2025-073442","DOIUrl":"https://doi.org/10.1542/peds.2025-073442","url":null,"abstract":"OBJECTIVEThe objective of this study was to evaluate required culture-based overseas tuberculosis (TB) screening in US-bound international adoptees.METHODSWe conducted a cross-sectional analysis of 22 053 international adoptees who underwent TB screening overseas and arrived in the United States during 2016 to 2023.RESULTSOf 22 053 international adoptees (aged younger than 18 years) screened for TB overseas, 12 (54 cases/100 000 persons) were diagnosed with TB disease, and 169 (766 cases/100 000 persons) had suspected TB disease (defined for this analysis as a chest radiograph or clinical signs/symptoms suggestive of TB or known HIV infection but negative sputum culture results overseas). Of 15 386 persons who underwent a tuberculin skin test (TST) or interferon-γ release assay (IGRA) overseas, 390 (2.5%) were diagnosed with latent TB infection (LTBI). Among 12 persons who initiated treatment of TB disease overseas, 10 (83.3%) completed post-arrival evaluation in the United States; of these, none were diagnosed with TB disease after arrival. Among 169 persons diagnosed overseas with suspected TB disease, 108 (63.9%) completed post-arrival evaluation; of these, 2 (1.9%) were diagnosed with TB disease. Among 390 persons diagnosed overseas with LTBI, 220 (56.4%) completed post-arrival evaluation; of these, none were diagnosed with TB disease. Of 150 persons diagnosed with LTBI at post-arrival evaluation, 137 (91.3%) were recommended for treatment; of these, 104 (75.9%) initiated and 79 (57.7%) completed treatment.CONCLUSIONSUS-bound international adoptees have a similarly high prevalence of TB disease compared with US-bound immigrant and refugee children, highlighting the importance of TB screening before immigration and ensuring timely recommended post-arrival evaluation.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"53 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147346408","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

Epidemiology of Herpes Simplex Virus in Infants Aged 0-42 Days: 2008-2024. 0-42天婴幼儿单纯疱疹病毒流行病学：2008-2024。

IF 8 2区医学

Pediatrics Pub Date : 2026-03-03 DOI: 10.1542/peds.2025-073629

Tara L Greenhow,Zahra Samiezade-Yazd,Lea Bornstein,Beverly R Young,Tran H P Nguyen

{"title":"Epidemiology of Herpes Simplex Virus in Infants Aged 0-42 Days: 2008-2024.","authors":"Tara L Greenhow,Zahra Samiezade-Yazd,Lea Bornstein,Beverly R Young,Tran H P Nguyen","doi":"10.1542/peds.2025-073629","DOIUrl":"https://doi.org/10.1542/peds.2025-073629","url":null,"abstract":"BACKGROUNDInfant herpes simplex virus (HSV) incidence ranges from 1.7 to 13.4 per 100 000 live births, varies by region, and prior to 2019, has been increasing. HSV-1 has surpassed HSV-2 as the predominant subtype. We aimed to report trends in infant HSV disease.METHODSThis was a retrospective study of infants aged 0-42 days born between October 1, 2008 to September 30, 2024 with HSV disease. Demographics, clinical symptoms, type of HSV disease, and subtype of HSV were captured. Trends of HSV disease and subtype were reported.RESULTSIn our 16-year cohort of 632 979 infants, we identified 62 cases of HSV disease, with a cumulative incidence of 9.8 (95% CI 7.6-12.5) per 100 000 births. The cumulative incidence of skin, eye, and/or mouth (SEM), disseminated (DIS), and central nervous system (CNS) disease were 5.4 (95% CI 3.7-7.5), 2.8 (95% CI 1.7-4.5), and 1.6 (95% CI 0.8-2.9) per 100 000 births, respectively. SEM and CNS disease incidence remained stable during the study period. However, there was a statistically significant change in the incidence of DIS disease between 2008-2021 and 2021-2024 with a rise in DIS disease of 4.5 per 100 000 births per year from 2021 to 2024. HSV-1 disease occurred in 61% and HSV subtype distribution was stable over time.CONCLUSIONSEM disease and HSV-1 were predominant throughout the study period. Incidence of DIS disease increased significantly after the COVID-19 pandemic, likely reflecting changing sexual practices during the pandemic and a population vulnerable to primary HSV-1 genital lesions.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"45 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147329189","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

Improving Capture of Race and Ethnicity Data in a Regional Neonatal Intensive Care Unit. 改进地区新生儿重症监护病房的种族和民族数据采集。

IF 8 2区医学

Pediatrics Pub Date : 2026-03-03 DOI: 10.1542/peds.2025-072493

Jeffrey M Meyers,Diane Prinzing,Rebecca L Kanaley,Paula Emrich,Mallory Prideaux,Angelica Trybulska,Anne Fallon,

{"title":"Improving Capture of Race and Ethnicity Data in a Regional Neonatal Intensive Care Unit.","authors":"Jeffrey M Meyers,Diane Prinzing,Rebecca L Kanaley,Paula Emrich,Mallory Prideaux,Angelica Trybulska,Anne Fallon, ","doi":"10.1542/peds.2025-072493","DOIUrl":"https://doi.org/10.1542/peds.2025-072493","url":null,"abstract":"BACKGROUND/OBJECTIVEAddressing disparities and improving outcomes for patients in a neonatal intensive care unit (NICU) requires accurate and reliable reporting of race and ethnicity. We sought to increase the percentage of infants with caregiver-reported race and ethnicity at NICU discharge to greater than 90% using quality improvement (QI) methods.METHODSWe first identified drivers including standardization, increasing reliability, and addressing gaps in education and health literacy. Tests of change included revising forms to enhance clarity and support equity, addressing barriers to the reliable processing of paper forms, real-time auditing and clinical decision support in the electronic health record, and development of a patient portal prebirth electronic form. Statistical process control charts were used to track the outcome measure, the percentage of patients in a NICU who had caregiver-reported race and ethnicity documented at discharge, and the process measure of the percentage of infants whose forms were received within 7 days of admission.RESULTSThe average percentage of patients with caregiver-reported race and ethnicity documented at NICU discharge increased from 38% to 94%. The percentage of forms received within 7 days of admission increased from 81% to 96%. Improvements have been sustained for more than 18 months.CONCLUSIONWe improved the documentation of caregiver-reported race and ethnicity among patients discharged from our NICU through rigorous QI methods. Accurate and reliable capture of race and ethnicity data should help identify and address disparities and improve care for all infants.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":"38 1","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147329188","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

Characteristics of Youth Treated With GLP-1RAs at an Integrated Weight Management Clinic. 综合体重管理诊所青少年GLP-1RAs治疗的特点

IF 6.4 2区医学

Pediatrics Pub Date : 2026-03-02 DOI: 10.1542/peds.2025-074094

Emily F Gregory, Rachana D Shah, Jeremy J Michel, Zia H Huballah, Nia A Frederick, Deepthi Gunturi, Emma K Edmondson

{"title":"Characteristics of Youth Treated With GLP-1RAs at an Integrated Weight Management Clinic.","authors":"Emily F Gregory, Rachana D Shah, Jeremy J Michel, Zia H Huballah, Nia A Frederick, Deepthi Gunturi, Emma K Edmondson","doi":"10.1542/peds.2025-074094","DOIUrl":"https://doi.org/10.1542/peds.2025-074094","url":null,"abstract":"Objectives: Youth use of GLP-1RAs is increasing. This study described GLP-1RA prescription patterns and barriers to treatment at a pediatric integrated weight management clinic.Methods: This retrospective cohort included youth 12 to 17 years with BMI at least 95th% for age and sex, with at least 1 visit at an integrated weight management program from January 2023 to August 2025. We identified youth with at least 1 GLP-1RA prescription in the electronic health record. We assessed demographic factors (age, sex, race, ethnicity, insurance payer, preferred language) and health factors (BMI, Type 2 diabetes, results of ALT, cholesterol, and hemoglobin A1c testing). Logistic regression assessed for an association between GLP-1RA prescription and demographic and health factors. Manual medical record review of a subsample of 102 youth with GLP-1RA prescriptions described reasons for interruptions in use.Results: Of 1647 youth, 325 (20%) had at least 1 GLP-1RA prescription. Odds of prescription increased with increasing age, increasing BMI, abnormal laboratory testing results, and non-Hispanic white or Hispanic race and ethnicity (compared with non-Hispanic Black). Odds of a prescription decreased with a preferred language other than English. In medical record review, 65 youth (64%) experienced GLP-1RA treatment interruptions, most commonly related to cost and insurance coverage.Conclusions: At one institution's integrated weight management program, 20% of potentially eligible youth were prescribed GLP-1RAs. Prescriptions were more likely for older patients and those with comorbid conditions, and less likely for Black or non-English speaking patients, reflecting known pediatric health disparities. Barriers to treatment were common after the prescription.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.4,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326825","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

Disparities in Medication Treatment of Type 2 Diabetes and Obesity. 2型糖尿病和肥胖症药物治疗的差异。

IF 6.4 2区医学

Pediatrics Pub Date : 2026-03-02 DOI: 10.1542/peds.2025-074840

Rachel Whooten, Leora Allen, Fatima C Stanford

引用次数: 0