Current Problems in Pediatric and Adolescent Health Care最新文献

{"title":"Reducing pediatric healthcare plastic pollution: Call to action","authors":"Hilary Ong MD","doi":"10.1016/j.cppeds.2026.101925","DOIUrl":"10.1016/j.cppeds.2026.101925","url":null,"abstract":"<div><div>Plastic pollution is a growing global health threat, with healthcare an underrecognized contributor. Hospitals generate large volumes of single-use plastics from clinical care, pharmaceuticals, and sterile supply chains, accounting for nearly one-quarter of hospital waste. These materials, largely derived from fossil fuels, introduce more than 13,000 chemicals into the environment and frequently degrade into microplastics and nanoplastics that contaminate air, water, soil, and human biological systems. Children are uniquely vulnerable to plastic pollution due to developmental physiology and higher per-kilogram exposures. Pediatric health impacts may occur through micro- and nano-plastics and toxic plastic additives such as phthalates, bisphenols and per- and polyfluoroalkyl substances. Reducing healthcare plastic use and waste offers direct and immediate opportunities to reduce children’s exposures. Frontline clinical strategies to address healthcare plastic pollution include sustainability-oriented quality improvement efforts aimed at eliminating unnecessary single-use plastics, transitioning to safer material alternatives, optimizing clinical practice patterns, expanding reuse and reprocessing systems, and advancing regulatory policies that restrict harmful additives. Addressing healthcare plastic pollution is not only an environmental imperative but a critical pediatric health intervention.</div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"56 2","pages":"Article 101925"},"PeriodicalIF":3.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147311604","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}

{"title":"Editorial Board Page","authors":"","doi":"10.1016/S1538-5442(26)00017-9","DOIUrl":"10.1016/S1538-5442(26)00017-9","url":null,"abstract":"","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"56 2","pages":"Article 101930"},"PeriodicalIF":3.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147551025","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}

{"title":"Diagnosis across the fetal alcohol spectrum disorders (FASD) continuum","authors":"H. Eugene Hoyme MD ,&nbsp;Prachi E Shah MD ,&nbsp;Omar Abdul-Rahman MD FACMG","doi":"10.1016/j.cppeds.2025.101911","DOIUrl":"10.1016/j.cppeds.2025.101911","url":null,"abstract":"<div><div>Fetal Alcohol Spectrum Disorders (FASD) comprise a continuum of neurodevelopmental and physical disabilities resulting from the teratogenic effects of prenatal alcohol exposure. FASD is recognized as the leading cause of preventable developmental disabilities worldwide. Recent U.S. school-based studies estimate its prevalence at 11.3–50.0 per 1000 children (approximately 1–5 %), with rates in certain high-risk populations reaching up to 169 per 1000 (approximately 17 %).</div><div>Although early diagnosis is associated with improved long-term outcomes, FASD remains frequently underrecognized or misdiagnosed. Multiple factors contribute to this gap, including a shortage of specialized multidisciplinary diagnostic teams and the absence of a universally accepted diagnostic framework.</div><div>This narrative review examines recent advances in the clinical diagnosis of FASD and highlights areas for future research aimed at improving diagnostic precision. The evidence presented underscores a clear public health message: abstaining from alcohol consumption during pregnancy is the safest and most effective strategy to prevent FASD.</div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"56 1","pages":"Article 101911"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044476","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}

{"title":"The evaluation and care of children with suspected fetal alcohol spectrum disorders in the pediatric medical home: The importance of therapeutic alliance, longitudinal surveillance and trauma-informed care","authors":"Prachi E. Shah MD, MS ,&nbsp;Roxanne Chang MD ,&nbsp;H. Eugene Hoyme MD","doi":"10.1016/j.cppeds.2025.101912","DOIUrl":"10.1016/j.cppeds.2025.101912","url":null,"abstract":"<div><div>The evaluation and management of children with prenatal alcohol exposure and suspected fetal alcohol spectrum disorders (FASD) requires a multidisciplinary approach, grounded in the pediatric medical home. This process begins with the primary care provider who is often the initial point of contact for children presenting with developmental and behavioral concerns. An evaluation for a FASD requires the primary care provider to consider the effects of biological risk factors (e.g. genetic and mental health risks, maternal pregnancy risks, and history or prenatal substance exposures), and the role of co-occurring complex trauma, for which a trauma-informed, family-centered approach is necessary to mitigate secondary morbidities, and optimize future outcomes. In this article, we will present a holistic approach to evaluating a child with a suspected alcohol-related diagnosis, beginning with the <em>diagnostic interview</em> which centers on building a therapeutic alliance with the child and family grounded in a framework of trauma-informed care. We will consider the role of <em>equifinality and multifinality</em> in the evaluation of children with developmental and behavioral concerns and suspected prenatal alcohol exposure. We will briefly review the <em>Collaboration on FASD Prevalence (CoFASP) Clinical Diagnostic Guidelines for FASD</em>, and review the <em>neurobehavioral deficits associated with prenatal alcohol exposure and their developmental emergence</em> across the childhood spectrum, with suggestions for monitoring and intervention in primary care. We will also <em>highlight neurobehavioral similarities between FASDs and other neurodevelopmental disorders</em>, and we will discuss the <em>importance of trauma-informed care</em> to foster resilience and optimize future outcomes across the developmental lifespan in children and families with FASDs.</div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"56 1","pages":"Article 101912"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145985584","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}

{"title":"Utility of facial imaging and machine learning in the evaluation of fetal alcohol spectrum disorders","authors":"Diego A. Gomez BS ,&nbsp;Omar Abdul-Rahman MD","doi":"10.1016/j.cppeds.2025.101913","DOIUrl":"10.1016/j.cppeds.2025.101913","url":null,"abstract":"<div><div>The last two decades have witnessed a remarkable transformation in the integration of artificial intelligence in healthcare. Similarly, our understanding of fetal alcohol spectrum disorders (FASD) has expanded and the data points now being considered are far more granular. In this article, we will review how investigators have attempted to apply technological innovations to enhance our knowledge of FASD and to fill some of the gaps that exist regarding access to experienced diagnosticians. We will summarize the salient studies to date and highlight future directions in terms of how the technology can move from research to healthcare delivery.</div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"56 1","pages":"Article 101913"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946765","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}

{"title":"Foreword: Fetal alcohol spectrum disorders","authors":"Arthur H. Fierman M.D. (Editor-in-Chief)","doi":"10.1016/j.cppeds.2026.101914","DOIUrl":"10.1016/j.cppeds.2026.101914","url":null,"abstract":"","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"56 1","pages":"Article 101914"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031413","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}

{"title":"Editorial Board Page","authors":"","doi":"10.1016/S1538-5442(26)00005-2","DOIUrl":"10.1016/S1538-5442(26)00005-2","url":null,"abstract":"","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"56 1","pages":"Article 101918"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147387578","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}

{"title":"Pediatric metabolic and bariatric surgery: When is the right time to operate?","authors":"Mark Shacker BA ,&nbsp;Justine Chinn MD ,&nbsp;Janey S.A. Pratt MD ,&nbsp;Gillian L. Fell MD, PhD","doi":"10.1016/j.cppeds.2025.101882","DOIUrl":"10.1016/j.cppeds.2025.101882","url":null,"abstract":"<div><div>Pediatric obesity is a growing epidemic associated with serious long-term health consequences, including diabetes, cardiovascular disease, and reduced life expectancy. Metabolic and bariatric surgery (MBS) is a safe, effective, and durable treatment for adolescents with severe or refractory obesity; however, it remains significantly underutilized. As a consequence, children with severe obesity and associated comorbidities progress to an advanced stage of disease that can be even more challenging to treat than in adults. Current evidence demonstrates that MBS in adolescents achieves comparable or even superior weight loss and comorbidity resolution compared to adults, with favorable long-term safety profiles. In select cases, GLP-1 receptor agonists (GLP-1RAs), may be used as an adjunct to MBS. Current evidence for GLP-1RA use in the preoperative period is limited, although when reinitiated early in the postoperative period, they may be associated with improved weight loss outcomes. Despite strong guideline support, &lt;0.05 % of eligible children undergo MBS, likely due to poor access to adolescent MBS centers, limited insurance coverage, and a lack of awareness or misinformation surrounding MBS, among other causes. Multidisciplinary support including preoperative teaching, mental health services, and long-term postoperative follow-up is essential to the success of the procedure. Further research is needed to better characterize the disparities in access, improve outreach and education efforts, combat the stigma associated with adolescent MBS, and address this growing public health crisis.</div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 12","pages":"Article 101882"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679294","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}

{"title":"Editorial Board Page","authors":"","doi":"10.1016/S1538-5442(25)00168-3","DOIUrl":"10.1016/S1538-5442(25)00168-3","url":null,"abstract":"","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 12","pages":"Article 101894"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145719091","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}

{"title":"Establishing a high-quality, equitable adolescent bariatric surgery program","authors":"Sadie Crouch MA, BSN, RN ,&nbsp;Joselio Rodrigues de Oliveira Filho MD ,&nbsp;Cornelia Griggs MD, MPH ,&nbsp;Kanika Bowen-Jallow MD, MMS, FACS, FAAP","doi":"10.1016/j.cppeds.2025.101880","DOIUrl":"10.1016/j.cppeds.2025.101880","url":null,"abstract":"<div><div>Despite mounting data on the effectiveness and safety of adolescent metabolic and bariatric surgery, few adolescent bariatric surgery centers exist relative to the growing number of patients in need of services. This is accompanied by a widening gap in access to care among patients of varying socioeconomic statuses and ethnic backgrounds. The patients most affected by adolescent obesity are those with the least amount of access due to multifactorial and complex barriers to treatment. It has never been more important to identify and address these issues as institutions pursue adolescent bariatric program development. Key areas of focus should include gathering appropriate data, garnering institutional commitment, and planning program infrastructure. This article reviews the steps necessary to developing an adolescent bariatric surgery program while ensuring that the program is as equitable as it is effective.</div></div>","PeriodicalId":49086,"journal":{"name":"Current Problems in Pediatric and Adolescent Health Care","volume":"55 12","pages":"Article 101880"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145649857","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}