Current Problems in Pediatric and Adolescent Health Care最新文献_第2页

IF 3.7 4区医学

Current Problems in Pediatric and Adolescent Health Care Pub Date : 2025-12-01 Epub Date: 2025-12-12 DOI: 10.1016/S1538-5442(25)00168-3

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Establishing a high-quality, equitable adolescent bariatric surgery program 建立一个高质量、公平的青少年减肥手术项目。

IF 3.7 4区医学

Current Problems in Pediatric and Adolescent Health Care Pub Date : 2025-12-01 Epub Date: 2025-11-29 DOI: 10.1016/j.cppeds.2025.101880

Sadie Crouch MA, BSN, RN , Joselio Rodrigues de Oliveira Filho MD , Cornelia Griggs MD, MPH , Kanika Bowen-Jallow MD, MMS, FACS, FAAP

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Introduction: Adolescent bariatric surgery in modern pediatric practice 简介：青少年减肥手术在现代儿科实践。

IF 3.7 4区医学

Current Problems in Pediatric and Adolescent Health Care Pub Date : 2025-12-01 Epub Date: 2025-11-29 DOI: 10.1016/j.cppeds.2025.101883

Jun Tashiro

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Quality of life and body contouring surgery in adolescents after bariatric surgery: A scoping review 减肥手术后青少年的生活质量和身体轮廓手术：范围回顾。

IF 3.7 4区医学

Current Problems in Pediatric and Adolescent Health Care Pub Date : 2025-12-01 Epub Date: 2025-12-05 DOI: 10.1016/j.cppeds.2025.101881

Sofia Perez-Otero BS , Hermes A. Aponte Rivera MD , Allyson R Alfonso MD , Jun Tashiro MD, MPH , Daniel J Ceradini MD

{"title":"Quality of life and body contouring surgery in adolescents after bariatric surgery: A scoping review","authors":"Sofia Perez-Otero BS , Hermes A. Aponte Rivera MD , Allyson R Alfonso MD , Jun Tashiro MD, MPH , Daniel J Ceradini MD","doi":"10.1016/j.cppeds.2025.101881","DOIUrl":"10.1016/j.cppeds.2025.101881","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Body contouring surgery (BCS) is a common postoperative trajectory for adults following bariatric surgery, yet research on its application to adolescents is lacking. This scoping review aimed to map the available literature on quality of life (QoL) and potential for BCS in adolescents after bariatric surgery.</div></div><div><h3>Methods</h3><div>This review followed the Joanna Briggs Institute (JBI) guidance for scoping reviews and is reported in accordance with the PRISMA extension for Scoping Reviews (PRISMA-ScR). Three electronic databases were queried for studies regarding QoL and BCS in adolescents following bariatric surgery within the last 20 years. A descriptive and thematic analysis was conducted.</div></div><div><h3>Results</h3><div>Twenty-three studies met inclusion criteria. A total of 19 (82.6%) evaluated QoL and 4 (17.4%) explored the role of BCS in adolescents following bariatric surgery. The most common method of data collection was prospective study (65.2%). Two themes were described: QoL after bariatric surgery, which expressed improvement in several domains within 6 months, and role for BCS, which showed high interest in addressing residual excess skin and appearance. Gaps in the literature were identified, including a need for studies exploring mediators of QoL, predictors of compliance, and outcomes of BCS.</div></div><div><h3>Conclusions</h3><div>Studies describing residual symptoms and BCS in adolescents following bariatric surgery are lacking. BCS may complement bariatric surgery, but further research must be conducted to assess its safety in adolescents. By addressing the research gaps described in this review, physicians may have a better understanding of the needs of this population and how to counsel them.</div></div><div><h3>Level of evidence and type of study</h3><div>Level IV; Systematic Scoping Review</div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 12","pages":"Article 101881"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Foreword: Adolescent Bariatric Surgery in Modern Pediatric Practice 前言：青少年减肥手术在现代儿科实践。

IF 3.7 4区医学

Current Problems in Pediatric and Adolescent Health Care Pub Date : 2025-12-01 Epub Date: 2025-11-30 DOI: 10.1016/j.cppeds.2025.101889

Arthur H. Fierman M.D. (Editor in Chief)

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Metabolic and bariatric surgery for adolescents: Progress and persistent challenges 青少年代谢和减肥手术：进展和持续的挑战。

IF 3.7 4区医学

Current Problems in Pediatric and Adolescent Health Care Pub Date : 2025-12-01 Epub Date: 2025-12-06 DOI: 10.1016/j.cppeds.2025.101890

Zachary Ballinger MD MSCI , Jeremy Aidlen MD

{"title":"Metabolic and bariatric surgery for adolescents: Progress and persistent challenges","authors":"Zachary Ballinger MD MSCI , Jeremy Aidlen MD","doi":"10.1016/j.cppeds.2025.101890","DOIUrl":"10.1016/j.cppeds.2025.101890","url":null,"abstract":"<div><div>Pediatric obesity, the most common chronic childhood disease in the United States is associated with significant comorbidities that persist into adulthood and increase the risk of early mortality. Metabolic and bariatric surgery (MBS) is the most effective intervention for severe obesity with durable reductions in BMI and obesity-related comorbidities as compared with medical therapy. MBS utilization remains strikingly low. Nearly three million children currently meet eligibility criteria for MBS, yet only about 2500 procedures are performed annually. There are many barriers to accessing MBS, including subspecialty surgeon availability, cost and geographic concentration of multidisciplinary programs, and the substantial burden of perioperative outpatient visits. Primary care physicians remain hesitant to refer adolescents for MBS due to outdated concerns about surgical risks, growth disruption, and adherence to the ineffective strategy of “watchful waiting.” Insurance denials likewise remain a persistent challenge with approval of only 40 % of initial requests for pediatric MBS, leading to delays, program attrition, and widening disparities. These barriers are compounded by persistent socioeconomic and racial inequities. Minority and socioeconomically disadvantaged youth are disproportionately affected by obesity, yet less likely to receive early referral or access to specialized obesity care. At the time of surgery, these patients have higher BMI and more advanced comorbidities, reflecting systemic failures. Despite these challenges, MBS offers transformative, and often lifesaving, benefits. Addressing persistent disparities in access to care by improving physician education, expanding program access and capacity, and reforming insurance policies are essential steps toward equitable access to effective obesity treatment for all children.</div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 12","pages":"Article 101890"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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The learning curve of a pediatric bariatric surgery program: Lessons learned from the first 100 patients 儿童减肥手术项目的学习曲线：前100名患者的经验教训。

IF 3.7 4区医学

Current Problems in Pediatric and Adolescent Health Care Pub Date : 2025-12-01 Epub Date: 2025-11-27 DOI: 10.1016/j.cppeds.2025.101888

Nicolle Burgwardt , Christine Finck , Prabhath Mannam , Darren S. Tishler , Pavlos K. Papasavas , James M. Healy

{"title":"The learning curve of a pediatric bariatric surgery program: Lessons learned from the first 100 patients","authors":"Nicolle Burgwardt , Christine Finck , Prabhath Mannam , Darren S. Tishler , Pavlos K. Papasavas , James M. Healy","doi":"10.1016/j.cppeds.2025.101888","DOIUrl":"10.1016/j.cppeds.2025.101888","url":null,"abstract":"<div><h3>Introduction</h3><div>Pediatric obesity continues to be an epidemic and as a result, pediatric surgical programs are developing expertise in bariatric surgery to improve outcomes in these children. This study aims to characterize the pathway from initiation to designation by The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) as a Center of Excellence over the course of our first 100 patients, and examine the implementation and associated learning curve of an institutional pediatric bariatric program at a free-standing children’s hospital.</div></div><div><h3>Methods</h3><div>Retrospective review of prospectively collected data from the first 100 laparoscopic sleeve gastrectomy patients at a freestanding academic children’s hospital. Patients were separated into quartiles to evaluate outcome measures. Demographics, perioperative and follow-up data were collected to reflect the ASMBS recommended reporting standards.</div></div><div><h3>Results</h3><div>100 patients were reviewed from 2015–2022. Significant reductions were seen in average operative time (127.6 vs. 65.3 min, <em>p</em> < 0.001), supply cost ($9031.08 vs. $2918.92, <em>p</em> < 0.001), postoperative length of stay (3.2 vs. 2.0 days, <em>p</em> < 0.001), and postoperative narcotic usage (8.4 vs. 1.8 doses, <em>p</em> < 0.001), between the first and fourth quartiles. Beginning in 2019, quality improvement initiatives were developed annually.</div></div><div><h3>Conclusion</h3><div>Partnership with an established high-volume bariatric center and accumulation of experience, followed by systematic implementation of quality and safety measures through MBSAQIP, can substantially improve the care provided to adolescent patients during the building of a pediatric bariatric program.</div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 12","pages":"Article 101888"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Editorial Board Page 编委会页面

IF 3.7 4区医学

Current Problems in Pediatric and Adolescent Health Care Pub Date : 2025-11-01 Epub Date: 2025-12-10 DOI: 10.1016/S1538-5442(25)00176-2

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Keeping patients moving: Understanding appropriate adaptive devices for positioning and mobility 保持患者活动：了解适当的定位和活动的适应性装置。

IF 3.7 4区医学

Current Problems in Pediatric and Adolescent Health Care Pub Date : 2025-11-01 Epub Date: 2025-12-05 DOI: 10.1016/j.cppeds.2025.101879

Julie Will , Mi Ran Shin , Brooke Jerome , Karla Feitl , Amanda Hall , Olga Morozova

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Pediatric stroke: From emergent evaluation to rehabilitation 小儿中风：从紧急评估到康复。

IF 3.7 4区医学

Current Problems in Pediatric and Adolescent Health Care Pub Date : 2025-11-01 Epub Date: 2025-12-05 DOI: 10.1016/j.cppeds.2025.101878

Mejdi Najjar, Melissa Fleming

{"title":"Pediatric stroke: From emergent evaluation to rehabilitation","authors":"Mejdi Najjar, Melissa Fleming","doi":"10.1016/j.cppeds.2025.101878","DOIUrl":"10.1016/j.cppeds.2025.101878","url":null,"abstract":"<div><div>Pediatric stroke, though less common than adult stroke, is a significant cause of morbidity and mortality in children, affecting neonates, infants, and adolescents. Strokes in children could be due to ischemic, hemorrhagic, or venous-thrombotic events. Timely recognition and intervention to optimize neurologic outcomes and minimize long-term disability is most critical. Clinical symptoms are dependent on location of the stroke, but pediatric-specific challenges include higher prevalence of stroke mimics and more frequent seizures. Rapid diagnosis hinges on detailed history, neurologic examination, and emergent imaging, with MRI and angiography preferred for evaluating ischemia and vascular anomalies.</div><div>Hyperacute treatments include intravenous thrombolysis and mechanical thrombectomy. Risk factors are often multifactorial, including congenital heart disease, sickle cell disease, and thrombophilia. Acute complications may involve cerebral edema, hemorrhagic conversion, and post-stroke epilepsy.</div><div>Rehabilitation is essential and begins early in the intensive care unit. A multidisciplinary team—including physical, occupational, and speech therapists alongside physiatrists—supports recovery. Rehabilitation intervention includes uses of orthoses to improve function, prevent complications, impairment specific treatment including constraint-induced movement therapy (CIMT) and goal-oriented hypertonia management. Cognitive and communication impairments also require tailored therapies and school reintegration planning.</div><div>Although neural plasticity offers potential for recovery, many children experience persistent motor, cognitive, and psychosocial deficits. Early, aggressive rehabilitation and coordinated outpatient care are key to maximizing functional outcomes and improving long-term quality of life.</div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 11","pages":"Article 101878"},"PeriodicalIF":3.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145696049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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