Pediatrics最新文献_第3页

Nonmedical Use of Controlled Medications by Adolescents and Young Adults: Clinical Report. 青少年非医疗使用受管制药物：临床报告。

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-18 DOI: 10.1542/peds.2024-069298

Nicholas Chadi, Leslie Walker-Harding

引用次数: 0

Hepatitis C Virus Testing Among Perinatally Exposed Children: 2018 to 2020. 围产期暴露儿童的丙型肝炎病毒检测：2018 年至 2020 年。

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-15 DOI: 10.1542/peds.2024-067261

Kate R Woodworth, Samantha Distler, Daniel J Chang, Jackie Luong, Suzanne Newton, Amanda Akosa, Lauren Orkis, Bethany Reynolds, Cynthia Carpentieri, Teri Willabus, Anthony Osinski, Hanna Shephard, Umme-Aiman Halai, Caleb Lyu, Lindsey Sizemore, Amy Sandul, Van T Tong

{"title":"Hepatitis C Virus Testing Among Perinatally Exposed Children: 2018 to 2020.","authors":"Kate R Woodworth, Samantha Distler, Daniel J Chang, Jackie Luong, Suzanne Newton, Amanda Akosa, Lauren Orkis, Bethany Reynolds, Cynthia Carpentieri, Teri Willabus, Anthony Osinski, Hanna Shephard, Umme-Aiman Halai, Caleb Lyu, Lindsey Sizemore, Amy Sandul, Van T Tong","doi":"10.1542/peds.2024-067261","DOIUrl":"10.1542/peds.2024-067261","url":null,"abstract":"Objective: To assess the frequency of hepatitis C virus (HCV) testing among a population-based cohort of perinatally exposed children and identify factors associated with testing.Methods: Using a population-based surveillance cohort of perinatally exposed children born from 2018 to 2020 from 4 US jurisdictions (Georgia; Massachusetts; Allegheny County, Pennsylvania; and Los Angeles County, California), we describe the frequency, timing, and type of HCV testing among children and identify characteristics associated with having an HCV test result by the age of 2 to 3 years. Data were obtained from electronic laboratory reporting, vital records, and medical records.Results: Of 803 perinatally exposed children, 7 (1%) died before the age of 24 months. Of 796 children, health departments were unable to find medical records or laboratory reports for 181 (23%). Among those with medical record abstraction at 24 months or testing reported before the age of 3 years (n = 615), 50% had an HCV test. The majority (70% of those tested) were tested for HCV antibodies at the age of 18 months or later, although 9% had an HCV nucleic acid test at ages 2 to <6 months. No characteristics examined were found to be significantly associated with having testing reported.Conclusions: In this surveillance report, we identify the gaps in current testing among children perinatally exposed to hepatitis C. Provider education and resources for health departments for follow-up and linkage to care can improve the identification of children requiring treatment, a vital piece of HCV elimination.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625130","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

A Call to Pediatricians: How Can We Improve HCV Testing in Perinatally Exposed Infants? 致儿科医生：如何改进围产期暴露婴儿的 HCV 检测？

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-15 DOI: 10.1542/peds.2024-068246

Rachel L Epstein, Ravi Jhaveri

引用次数: 0

Inequities in Hepatitis Virus Testing for Perinatally Exposed Infants in Tennessee: 2018 to 2023. 田纳西州围产期暴露婴儿肝炎病毒检测的不公平现象：2018 年至 2023 年。

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-15 DOI: 10.1542/peds.2024-067260

Christine M Thomas, Heather Wingate, Shamia Roberts, Lindsey Sizemore, Mary-Margaret A Fill, Timothy F Jones, William Schaffner, John R Dunn

引用次数: 0

Macrophage Activation Syndrome in MIS-C. MIS-C 中的巨噬细胞活化综合征。

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-14 DOI: 10.1542/peds.2024-066780

Luisa Berenise Gámez-González, Chiharu Murata, Jimena García-Silva, Rolando Ulloa-Gutierrez, Martha Márquez-Aguirre, Itzel Ríos-Olivares, Enrique Faugier-Fuentes, Jesús A Domínguez-Rojas, Adriana Yock-Corrales, Martha I Álvarez-Olmos, Jaime Fernández-Sarmiento, Mónica Velasquez-Méndez, Gabriela Ivankovich-Escoto, Adriana H Tremoulet, Marco A Yamazaki-Nakashimada

{"title":"Macrophage Activation Syndrome in MIS-C.","authors":"Luisa Berenise Gámez-González, Chiharu Murata, Jimena García-Silva, Rolando Ulloa-Gutierrez, Martha Márquez-Aguirre, Itzel Ríos-Olivares, Enrique Faugier-Fuentes, Jesús A Domínguez-Rojas, Adriana Yock-Corrales, Martha I Álvarez-Olmos, Jaime Fernández-Sarmiento, Mónica Velasquez-Méndez, Gabriela Ivankovich-Escoto, Adriana H Tremoulet, Marco A Yamazaki-Nakashimada","doi":"10.1542/peds.2024-066780","DOIUrl":"https://doi.org/10.1542/peds.2024-066780","url":null,"abstract":"Background: Multisystem inflammatory syndrome (MIS-C) represents a diagnostic challenge because of its overlap with Kawasaki disease, Kawasaki disease shock syndrome, and toxic shock syndrome. Macrophage activation syndrome (MAS) is a frequently fatal complication of various pediatric inflammatory disorders and has been reported in MIS-C. Early diagnosis and prompt initiation by immune modulating therapies are essential for effectively managing MAS.Methods: We conducted a retrospective study to determine the frequency, natural history, diagnostic metrics, treatment, and outcome of MAS in MIS-C within a large cohort of patients across 84 Latin American centers in 16 countries. We compared the clinical and laboratory characteristics between patients with and without MAS.Results: Among 1238 patients with MIS-C, 212 (17.1%) fulfilled MAS criteria. Gastrointestinal and neurologic manifestations were more frequent in cases where MIS-C was complicated by MAS. Patients presenting with MIS-C complicated by MAS had a mortality rate of 12%, which was higher than those without it. Mortality was associated with MAS, seizures, arthritis, and shock. A ferritin or erythrocyte sedimentation rate ratio of >18.7 exhibited a sensitivity of 88.2% and a specificity of 75% in diagnosing MAS in MIS-C.Conclusions: MAS in MIS-C patients is associated with increased morbidity and mortality rates in the largest MIS-C Latin American cohort. Early recognition and appropriate management are crucial in improving patient outcomes and reducing mortality rates.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625763","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

The Importance of Differentiating MIS-C From Other Hyperinflammatory Conditions. 将 MIS-C 与其他高炎症性疾病区分开来的重要性

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-14 DOI: 10.1542/peds.2024-068657

Victoria Ronan, Jason M Kane

引用次数: 0

Implementation of Immunization Services Through a Pediatric Urgent Care Clinic. 通过儿科急诊诊所实施免疫服务。

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-14 DOI: 10.1542/peds.2023-064079

David M Gordon, Tonia Vega, Sabreen Aulakh, Aarohi Bhargava-Shah, Naomi S Bardach, Shonul Jain

{"title":"Implementation of Immunization Services Through a Pediatric Urgent Care Clinic.","authors":"David M Gordon, Tonia Vega, Sabreen Aulakh, Aarohi Bhargava-Shah, Naomi S Bardach, Shonul Jain","doi":"10.1542/peds.2023-064079","DOIUrl":"https://doi.org/10.1542/peds.2023-064079","url":null,"abstract":"Background and objectives: Pediatric urgent care (PUC) centers may bolster immunization campaigns by offering vaccination during acute care visits, but few such programs have been described.Methods: We conducted a quality improvement initiative at an academically affiliated federally qualified health center that provides primary, specialty, and PUC services to children. Our PUC began offering routine immunizations in July 2020. The percentage of visits by eligible patients age ≤21 years during which immunization screening (process) and administration (outcome) occurred was measured from March 1, 2021, to February 19, 2023. Administration rates were measured across age, sex, race, language, and medical home groups. Data were analyzed with statistical process control methods. Grievance and adverse event data were monitored (balancing).Results: We completed 4 plan-do-study-act cycles. Provider-facing bundles that included training, decision support, electronic health record signaling, and financial incentives were not associated with meaningful changes in screening and administration (cycles 1-3). A dedicated nurse vaccinator (DNV) was added on October 31, 2022 (cycle 4). The mean screening rate increased from 44.7% to 67.4% during the DNV period, and the mean administration rate increased from 26.5% to 50.8%. Lower administration rates were observed during visits by Black and English-speaking patients, and by patients empaneled outside our site.Conclusions: Provider-facing interventions alone were not effective at increasing vaccine screening and administration in our PUC, but marked improvement was observed with the addition of a DNV. Future interventions are needed to address disparities. Additional investigation is needed to determine whether our results are reproducible in other PUCs with access to vaccines.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625402","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

Clinical Pathways Programs in Children's Hospitals. 儿童医院的临床路径计划。

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-13 DOI: 10.1542/peds.2023-065553

Leigh Anne Bakel, Ilana Y Waynik, Amy J Starmer, Adam K Berkwitt, Sonja I Ziniel

{"title":"Clinical Pathways Programs in Children's Hospitals.","authors":"Leigh Anne Bakel, Ilana Y Waynik, Amy J Starmer, Adam K Berkwitt, Sonja I Ziniel","doi":"10.1542/peds.2023-065553","DOIUrl":"https://doi.org/10.1542/peds.2023-065553","url":null,"abstract":"Background and objective: Clinical pathways translate best evidence into the local context of a care setting through structured, multidisciplinary care plans. Little is known about clinical pathway programs in pediatric settings. The purpose of this study was to determine the prevalence of clinical pathway programs and describe similarities and differences.Methods: We performed a cross-sectional web survey to assess the existence of a clinical pathway program, number, type, and creation or revision of clinical pathways, and its characteristics in the 111 hospitals of the Pediatric Research in Inpatient Settings network.Results: Eighty-one hospitals responded to the survey (73% response rate). Most hospitals had a clinical pathway program (63%, n = 50 of 80) that was hospital-wide (70%, n = 35 of 50). Freestanding children's (48%, n = 39 of 81), academic (60%, n = 43 of 72), teaching hospitals (96%, n = 78 of 81) made up the largest proportion of survey respondents. There was no funding for nearly half of the programs (n = 21 of 46, 46%). Over a quarter of survey respondents reported no data collected to assess pathway utilization and/or care outcomes (n = 19 of 71, 27%).Conclusions: Greater than half of respondents confirmed existence of a program. Freestanding, academic teaching hospitals accounted for the most responses. However, nearly half of surveyed programs were unfunded, and many are unable to measure their pathway outcomes or demonstrate improvement in care. Survey respondents were enthusiastic about participating in a national collaborative on pediatric clinical pathways.","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142624742","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

A Vaccine Clinic for Individuals With Neurodevelopmental Disabilities. 为有神经发育障碍的人开设疫苗诊所。

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-13 DOI: 10.1542/peds.2023-064034

Van Kim Ma, Erin Roseborough, Veronica Tuss, Melissa Mello, Katharine Harlan Owens, Aubyn Stahmer, Roger Scott Akins

引用次数: 0

Factors Associated With Parents Asking Other Parents About Firearms in the Home. 父母向其他父母询问家中枪支情况的相关因素。

IF 6.2 2区医学

Pediatrics Pub Date : 2024-11-13 DOI: 10.1542/peds.2024-068061

Samaa Kemal, Carly Menker, Tyler Lennon, Michelle L Macy, Karen M Sheehan, Megan M Attridge, Audrey G Brewer, Marie E Heffernan

引用次数: 0