Pediatrics最新文献

{"title":"ADHD Prescription Patterns: Paying Attention to Trends.","authors":"Sarah Weas, William J Barbaresi","doi":"10.1542/peds.2024-069093","DOIUrl":"10.1542/peds.2024-069093","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047303","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":"Vaccination Timing: Threading the Needle Between \"Too Early\" and \"Too Late\".","authors":"David G Bundy","doi":"10.1542/peds.2024-068972","DOIUrl":"10.1542/peds.2024-068972","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952993","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":"Prescription Stimulant Dispensing to US Children: 2017-2023.","authors":"Sijia He, Sean Esteban McCabe, Rena M Conti, Anna Volerman, Kao-Ping Chua","doi":"10.1542/peds.2024-068558","DOIUrl":"10.1542/peds.2024-068558","url":null,"abstract":"<p><p></p><p><strong>Objective: </strong>To evaluate changes in prescription stimulant dispensing to children aged 5 to 17 years associated with the COVID-19 pandemic and the shortage of immediate-release mixed amphetamine salts (Adderall), which was announced in October 2022.</p><p><strong>Methods: </strong>We analyzed the 2017 to 2023 IQVIA Longitudinal Prescription Database, which captures 92% of US prescriptions. Using an interrupted time series design, we evaluated level and slope changes in the monthly stimulant-dispensing rate (number of children with stimulant dispensing per 100 000 children) in March 2020 and October 2022.</p><p><strong>Results: </strong>In March 2020, the monthly stimulant-dispensing rate to children declined -454.9 children per 100 000 (95% CI, -572.6 to -337.2), an 18.8% decrease relative to January 2017. After March 2020, this rate increased to 12.7 children per 100 000 per month (95% CI, 6.6-18.8). In October 2022, there was no level change (-39.7 children per 100 000; 95% CI, -189.9 to 110.5) or slope change (-12.1 children per 100 000 per month; 95% CI, -27.5 to 3.3), although estimates were negative. During October 2022, there was a level decrease in the monthly dispensing rate for immediate-release mixed amphetamine salts and a level increase in the monthly dispensing rate for dexmethylphenidate.</p><p><strong>Conclusions: </strong>Stimulant dispensing to children declined after the pandemic began. Dispensing may also have declined after October 2022, but estimates were not significant, partly because decreased dispensing of immediate-release mixed amphetamine salts was offset by increased dispensing of other stimulants. Findings suggest the shortage may have prompted children to switch to alternative stimulants. Future research should evaluate whether any switches led to adverse events.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047309","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":"Pleural Tuberculoma Presenting as a Solitary Pleural Mass in a Child.","authors":"Ayano Watanabe, Takehisa Sano, Kenta Murayama, Nobuhiro Shimura, Emiko Nakagawa, Toshihiro Masuda, Masato Fujii","doi":"10.1542/peds.2024-068169","DOIUrl":"10.1542/peds.2024-068169","url":null,"abstract":"<p><p>Pleural tuberculoma is often observed during treatment for tuberculous pleurisy; however, this condition is rarely found as a solitary pleural nodule in patients without a history of tuberculosis treatment, and no cases have been reported in children. We report a case of a 12-year-old boy with pleural tuberculoma presenting as a solitary mass. He had a fever and cough that prompted chest radiography, which revealed a mass in the right lung. Symptoms improved with antibacterial medication; however, computed tomography (CT) revealed a 4.5-cm pleural mass that partially bordered the ribs. CT-guided biopsy revealed a necrotizing granuloma, but the real-time polymerase chain reaction result for Mycobacterium tuberculosis was negative. Malignant diseases, such as osteosarcoma, could not be ruled out; thus, surgical resection was performed, and pleural tuberculoma was diagnosed. The patient was treated with antituberculosis drugs for 6 months, and no recurrence was observed in the following 2 years. Pleural tuberculomas should be considered in the differential diagnosis of solitary pleural tumors, especially in countries where tuberculosis is endemic.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922587","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":"A Bundled, Practice-Based Intervention to Increase HPV Vaccination.","authors":"Peter G Szilagyi, Alexander G Fiks, Cynthia M Rand, Mary Kate Kelly, A Russell Localio, Christina S Albertin, Sharon G Humiston, Robert W Grundmeier, Jennifer Steffes, Kristin Davis, Laura P Shone, Greta McFarland, Dianna E Abney, Alisa J Stephens-Shields","doi":"10.1542/peds.2024-068145","DOIUrl":"10.1542/peds.2024-068145","url":null,"abstract":"<p><p></p><p><strong>Background and objectives: </strong>Human papillomavirus (HPV) vaccination rates are suboptimal, and missed vaccination opportunities are common. We hypothesized that a bundled intervention improves missed HPV vaccination opportunities.</p><p><strong>Methods: </strong>We used a pre-post design to assess differences in HPV vaccine missed opportunities (visits when vaccine-eligible adolescents are not vaccinated). We compared rates for a 12-month period before vs those for a 6-month period (February 23, 2022, to August 9, 2022) during a bundled intervention. We implemented the bundled intervention in 24 primary care pediatric practices that had been usual care controls for a prior randomized trial. The bundled intervention involved 3 components: online clinician training on HPV vaccine communication, performance feedback on missed HPV vaccination opportunities, and clinician prompts for HPV vaccination. As a secondary analysis, we compared missed opportunities for these 24 practices vs 48 contemporaneous comparison group practices identified retrospectively.</p><p><strong>Results: </strong>For well-child care (WCC) visits, missed HPV vaccination opportunities were improved during vs before the intervention by 4.8 percentage points (95% CI, -7.2% to -2.4%) for initial HPV vaccine doses and a modest 2.2 percentage points (95% CI, -4.4% to -0.0%) for subsequent doses. For other visit types, findings ruled out changes beyond minimal improvements. Missed vaccination opportunity rates for initial HPV vaccination at WCC visits were similar for the 24 intervention practices vs the 48 comparison practices for a 4.5-year period before the intervention, but they improved for intervention practices and worsened for comparison practices during the intervention period (difference, -6.6%; 95% CI, -9.3% to -3.8%).</p><p><strong>Conclusions: </strong>This bundled intervention appeared to improve HPV vaccination during WCC visits.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932603","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":"There Are No Bad Kids: An Antiracist Approach to Oppositional Defiant Disorder.","authors":"Rupinder K Legha","doi":"10.1542/peds.2024-068415","DOIUrl":"10.1542/peds.2024-068415","url":null,"abstract":"","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952990","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":"Invalid Vaccine Doses Among Children Aged 0 to 35 Months: 2011 to 2020.","authors":"Alexandria N Albers, Sarah Y Michels, Matthew F Daley, Jason M Glanz, Sophia R Newcomer","doi":"10.1542/peds.2024-068341","DOIUrl":"10.1542/peds.2024-068341","url":null,"abstract":"<p><p></p><p><strong>Background and objectives: </strong>Vaccine doses provided outside the Advisory Committee on Immunization Practices for minimum and maximum ages of vaccination and minimum intervals between doses are considered invalid. Our objective was to quantify the prevalence of and factors associated with invalid doses among US children aged 0 to 35 months.</p><p><strong>Methods: </strong>We analyzed provider-verified vaccination records from the nationally representative 2011-2020 National Immunization Survey-Child. We quantified the number of children with at least 1 invalid vaccine dose overall, by survey year, and by vaccine type. Among children who received vaccine doses before the minimum age or minimum dose interval, we quantified the prevalence of receiving extra doses such that series were completed with the recommended number of valid doses. We used logistic regression models to identify factors associated with receipt of an invalid vaccination.</p><p><strong>Results: </strong>Of 161 187 children, 22 209 (weighted percent: 15.4%, 95% CI, 15.0%-15.8%) had an invalid vaccine dose. Of children with a minimum age or minimum interval invalid dose, 44.9% (95% CI, 43.2%-46.6%) received extra doses and completed the series. The highest prevalence of invalid doses was for 3-dose rotavirus (n = 5733, 4.4%), with the first dose being administered after the maximum age (n = 3996, 3.1%). Overall, the percentage of children with an invalid dose decreased from 2011 (16.9%) to 2020 (12.5%). Children who moved across state lines vs not (adjusted odds ratio: 1.5 [95% CI, 1.4-1.6]) had higher odds of an invalid vaccine dose.</p><p><strong>Conclusions: </strong>Although invalid vaccine doses have decreased over time, many children with invalid doses lacked the doses necessary to complete a vaccine series.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952943","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":"Parental and Medical Classification of Neurodevelopment in Children Born Preterm.","authors":"Lindsay L Richter, Annie Janvier, Rebecca Pearce, Claude Julie Bourque, Paige T Church, Thuy Mai Luu, Anne Synnes","doi":"10.1542/peds.2024-066148","DOIUrl":"10.1542/peds.2024-066148","url":null,"abstract":"<p><strong>Background and objectives: </strong>The likelihood and severity of neurodevelopmental impairment (NDI) affects critical health care decisions. NDI definitions were developed without parental perspectives. We investigated the agreement between parental vs medical classification of NDI among children born preterm.</p><p><strong>Methods: </strong>In this multicenter study, parents of children born preterm (<29 weeks) evaluated at 18 to 21 months corrected age (CA) were asked whether they considered their child as developing normally, having mild/moderate impairment, or having severe impairment. Medical categorization was based on hearing, vision, cerebral palsy status, and Bayley Scales of Infant and Toddler Development Third Edition (Bayley-III) scores. Agreement was analyzed using Cohen's weighted κ. Discrepancies in categorization by NDI components and parental demographics were examined using the Pearson χ2 test, Fisher exact test, or Wilcoxon signed-rank test.</p><p><strong>Results: </strong>Children (n = 1098, gestational age 26.1 ± 1.5 weeks, birthweight 919 ± 247 g) were evaluated at 19.6 ± 2.6 months CA at 13 clinics. Agreement between parental and medical NDI classification was poor (κ = 0.30; 95% CI: 0.26-0.35). Parents described their child's development as normal or less impaired. Only 12% of parents of children classified as having a severe NDI according to the medical definition agreed. There were significant disagreements between classification for children based on Bayley-III cognitive, language, and motor scores but not for cerebral palsy. Discrepancies varied by parental education and ethnicity but not by single caregiver status.</p><p><strong>Conclusions: </strong>Parent perception of NDI differs from medical categorization, creating a risk of miscommunication. This indicates an overestimation of the impact of disability by clinicians, which may affect life-and-death decisions. Parental perspectives should be considered when reporting and discussing neurodevelopmental outcomes.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952984","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":"Caregiver and Child Adverse Childhood Experiences: A Meta-Analysis.","authors":"Jenney Zhu, Audrey-Ann Deneault, Jessica Turgeon, Sheri Madigan","doi":"10.1542/peds.2024-068578","DOIUrl":"10.1542/peds.2024-068578","url":null,"abstract":"<p><strong>Context: </strong>Exposure to adverse childhood experiences (ACEs) is associated with adverse impacts on subsequent generations. The extent to which caregiver ACEs are associated with their child's ACE score is unclear.</p><p><strong>Objective: </strong>To meta-analytically examine the association between caregiver and child ACE score. Potential moderators of this association were explored.</p><p><strong>Data sources: </strong>Systematic searches were conducted using MEDLINE, Embase, PsycINFO, and CINHAL from 1998, the year the ACEs questionnaire was published, to February 19, 2024.</p><p><strong>Study selection: </strong>Inclusion criteria were that the ACEs questionnaire was completed for both caregiver and child, an effect size was available, and the study was published in English.</p><p><strong>Data extraction: </strong>Variables extracted included sample size and magnitude of association between caregiver ACEs and child ACEs, mean caregiver and child age, sex (% female), race and ethnicity, and informant of ACEs.</p><p><strong>Results: </strong>Seventeen samples (4872 caregiver-child dyads) met inclusion criterion. Results revealed a large pooled-effect size between caregiver and child ACEs (r = 0.33; 95% CI, 0.25-0.41; P < .001), such that higher caregiver ACEs score was associated with higher child ACEs score. This association was stronger among studies with younger caregivers and studies that utilized caregiver-report compared with child self-report of ACEs.</p><p><strong>Limitations: </strong>Many studies were conducted in North America with female caregiver samples, limiting generalizability beyond these populations.</p><p><strong>Conclusions: </strong>Caregiver ACEs were strongly associated with child ACEs. Prevention and intervention efforts for caregivers should be trauma informed and focused on bolstering protective factors that may break cycles of intergenerational risk.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971778","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":"Late-Onset Sepsis Among Extremely Preterm Infants During the COVID-19 Pandemic.","authors":"Sagori Mukhopadhyay, David A Kaufman, Shampa Saha, Karen M Puopolo, Dustin D Flannery, Kristin E D Weimer, Rachel G Greenberg, Pablo J Sanchez, Eric C Eichenwald, Charles M Cotten, Barbara J Stoll, Abbot Laptook","doi":"10.1542/peds.2024-067675","DOIUrl":"10.1542/peds.2024-067675","url":null,"abstract":"<p><p></p><p><strong>Objectives: </strong>To compare incidence of late-onset sepsis (LOS) among extremely preterm infants before and during the COVID-19 pandemic.</p><p><strong>Methods: </strong>Multicenter cohort study of infants with birthweight 401 to 1000 g or gestational age 22 to 28 weeks. LOS was defined as a bacterial or fungal pathogen isolated from blood or cerebrospinal fluid culture obtained after 72 hours of age. Primary outcome was LOS incidence calculated as incidence proportion (LOS cases among all admissions) and incidence rate (LOS events/1000 patient days). A multivariable Poisson regression model was used to compare the adjusted risk of LOS incidence proportion before (1/1/18-3/31/20) and during the pandemic (4/1/20-12/31/21). An interrupted time series analysis using a generalized linear mixed model with center as a random effect was used to compare LOS incidence rates during the 2 periods.</p><p><strong>Results: </strong>Among 6509 eligible infants, LOS incidence proportion was not different before (18.2%) and during the pandemic (16.9%; P = .18). The adjusted relative risk (95% CI) for LOS was 0.93 (0.82-1.05) and for LOS or mortality was 0.98 (0.88-1.08) during the pandemic compared to the period before the pandemic. In the interrupted time series analysis, there was no significant change in LOS incidence rates at the start of the pandemic (0.219, 95% CI, -0.453 to 0.891) or microbiology of LOS, and change in trends of LOS incidence rates before and during the pandemic was not significant (-0.005, 95% CI, -0.025 to 0.015).</p><p><strong>Conclusions: </strong>In a large multicenter study of extremely preterm infants, rates of LOS remained unchanged during the pandemic.</p>","PeriodicalId":20028,"journal":{"name":"Pediatrics","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024543","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}