Journal of Pediatric Health Care最新文献

{"title":"Community-acquired Clostridioides Difficile Infection: An Update for the Primary Care Nurse Practitioners Caring for Children and Adolescents.","authors":"Katherine H Peppers","doi":"10.1016/j.pedhc.2025.07.007","DOIUrl":"https://doi.org/10.1016/j.pedhc.2025.07.007","url":null,"abstract":"","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823111","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":"Interpreting Serum-Specific IgE Panels: Key Insights for Pediatricians in Diagnosing Food Allergies in Children.","authors":"Kaity Fashho, Matthew Garber, Ejaz Yousef","doi":"10.1016/j.pedhc.2025.07.004","DOIUrl":"https://doi.org/10.1016/j.pedhc.2025.07.004","url":null,"abstract":"<p><strong>Background: </strong>This study was prompted by a case of a 5-year-old boy misdiagnosed with \"multiple food allergies\" based on serum-specific IgE (SSIgE) tests ordered by his primary care physician, despite consuming the suspected allergens without issues. The purpose of this retrospective study was to evaluate the accuracy of SSIgE panel testing in diagnosing food allergies in children.</p><p><strong>Methods: </strong>Case report and retrospective study to evaluate the accuracy of SSIgE tests in diagnosing food allergies in children. The study included 646 patients who underwent oral food challenges.</p><p><strong>Results: </strong>Results indicated that while SSIgE tests have high negative predictive value, their specificity is poor, leading to unnecessary food avoidance.</p><p><strong>Conclusions: </strong>The findings highlight the need for cautious interpretation of SSIgE tests and recommend oral challenges for accurate diagnosis, aiming to prevent the negative impact of unnecessary dietary restrictions.</p>","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812619","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":"Integrated Healthcare for Youth in Foster Care: A Narrative Review.","authors":"Christina Quick, Mary Claire Meimers, Emma Buchele, Madeline Krawciw, Della Hughes, Amy Rohn","doi":"10.1016/j.pedhc.2025.06.012","DOIUrl":"https://doi.org/10.1016/j.pedhc.2025.06.012","url":null,"abstract":"<p><p>Integrated healthcare models combining behavioral and primary care provide solutions for vulnerable pediatric populations, especially youth in foster care, facing disproportionately high rates of chronic conditions and mental health issues. This review synthesizes current literature to assess the impact of integrated care on health outcomes for youth in foster care. Findings suggest integrated care can reduce healthcare barriers, improve coordination, and improve health outcomes for these youth. However, literature gaps indicate a need for more research. Clinical practice implications include adopting coordinated, multidisciplinary care. Future research should standardize definitions and approaches to support the sustainability of these care models.</p>","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785833","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":"A Missed Opportunity: Severe Malnutrition in an Infant Despite Routine Care Access.","authors":"Claire Kee","doi":"10.1016/j.pedhc.2025.07.006","DOIUrl":"https://doi.org/10.1016/j.pedhc.2025.07.006","url":null,"abstract":"<p><p>Severe malnutrition of an infant is rare in Canada but poses a major public health concern. This case report describes a 5-month-old male presenting with a rash, found to be severely malnourished with hypoglycemia, bradycardia, hypothermia, ketosis, and metabolic acidosis. Malnutrition was likely due to inadequate breastmilk supply and underfeeding. The infant was treated with intravenous fluids and carefully managed feeding plans while closely monitoring biochemical markers. His nutritional status gradually improved, normalizing symptoms and lab values. This case highlights the importance of early recognition of growth failure, timely referrals, and prevention of complications like refeeding syndrome.</p>","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762127","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":"Parenting Stress Trajectories in Parents of Children with Congenital Heart Disease.","authors":"Laurie Tremblay, Charles Lepage, Yara Maalouf, Jade Bayard, Amélie Doussau, Natacha Paquette, Annie Bernier, Marie Noëlle Simard, Célia Matte-Gagné, Anne Gallagher","doi":"10.1016/j.pedhc.2025.06.011","DOIUrl":"https://doi.org/10.1016/j.pedhc.2025.06.011","url":null,"abstract":"<p><strong>Objectives: </strong>This study examines parenting stress trajectories in parents of children with congenital heart disease from 4 to 60 months and identifies predictors.</p><p><strong>Methods: </strong>Sixty-six parents completed the Parenting Stress Index-Short Form (PSI-4-SF) at 4, 24, and 60 months of child's age. The PSI-4-SF provides a score on three dimensions of parenting stress: parental distress (PD), difficult child (DC), and parent-child dysfunctional interactions (PCDI). Multilevel growth curves were modeled to characterize the intraindividual evolution of parenting stress during early childhood.</p><p><strong>Results: </strong>PD and DC fluctuated, while PCDI decreased over time. Lower birthweight predicted higher DC at 4 months, and longer hospitalization after the first surgery predicted higher PCDI at 4 months. No predictor influenced PD.</p><p><strong>Conclusions: </strong>Parents with high PD and DC tend to remain highly stressed, highlighting the importance of early screening. Identifying predictors of specific stress dimensions can help professionals support at-risk families.</p>","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745845","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":"Evaluating the Lowest Post-IVIG Body Temperature as a Predictor of Treatment Response in Kawasaki Disease.","authors":"Wan-Fu Hsu, Pi-Chang Lee, Ying-Hsiu Lin, Chun-Chieh Hu, Chen-Yu Fan, Der-Shiun Wang, Yen-Mei Lee, Mei-Jy Jeng","doi":"10.1016/j.pedhc.2025.06.001","DOIUrl":"https://doi.org/10.1016/j.pedhc.2025.06.001","url":null,"abstract":"<p><strong>Introduction: </strong>Intravenous immunoglobulin (IVIG) is the standard therapy for Kawasaki disease (KD), reducing inflammation and coronary artery complications. However, some patients exhibit IVIG resistance. This study aimed to identify markers of IVIG efficacy in KD.</p><p><strong>Methods: </strong>A retrospective analysis included KD patients treated with IVIG from January 2011 to September 2023. Patients were divided into IVIG-sensitive and IVIG-resistant groups. Data from those diagnosed before October 2022 formed the development dataset, while later cases comprised the validation dataset.</p><p><strong>Results: </strong>Among 123 patients, 110 were IVIG-sensitive and 13 were IVIG-resistant. The lowest post-IVIG body temperature (BT) was significantly lower in the IVIG-sensitive group. A BT threshold of 36.05 °C showed sensitivity of 69.2% and specificity of 79.1%. Combining BT with pre-IVIG scoring systems improved specificity to 85.5%-93.6%.</p><p><strong>Discussion: </strong>The lowest post-IVIG BT is a potential predictor of IVIG response, enhancing accuracy when combined with scoring systems.</p>","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734991","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":"Improving Hospital Resource Utilization and Maintaining Quality of Care through a Nurse Practitioner-Led Pediatric Head Injury Outpatient Clinic.","authors":"Emma K Hartman, Stefanie R Hartman, Alfred P See","doi":"10.1016/j.pedhc.2025.06.013","DOIUrl":"https://doi.org/10.1016/j.pedhc.2025.06.013","url":null,"abstract":"<p><strong>Objective: </strong>The authors evaluated hospital resource utilization and care quality relative to the establishment of a PNP-led outpatient clinic for head injury care.</p><p><strong>Method: </strong>Charts for pediatric head injury patients at a single institution between 2017 and 2023 were reviewed and grouped relative to PNP-led clinic establishment on January 1, 2019.</p><p><strong>Results: </strong>Prior to clinic establishment, there were 217 unique patients with 1.16 visits per patient (with 20% seen by a PNP). Afterwards, there were 420 patients with 1.15 visits per patient (with 73% seen by a PNP). For symptomatic patients, PNPs provided return to school/activity planning, referrals to physical/occupational therapy and early intervention, and continued management after referral to subspecialty care at significantly higher rates. MDs referred symptomatic patients out of their care at significantly higher rates.</p><p><strong>Discussion: </strong>PNP-led outpatient clinics can manage nonemergent outpatient head injury case volume, increasing capacity to organize care for symptomatic patients, and maximizing value from hospital resource utilization.</p>","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709718","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":"Implementing The Food Ladder For Tolerance Acquisition In A Pediatric Case With Food Protein-Induced Enterocolitis Syndrome.","authors":"Halime Yağmur, Damla Baysal-Bakır, Gizem Kabadayı, Özge Atay, Nevin Uzuner","doi":"10.1016/j.pedhc.2025.06.010","DOIUrl":"10.1016/j.pedhc.2025.06.010","url":null,"abstract":"<p><strong>Background: </strong>Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy predominantly diagnosed in infancy and early childhood. The acute form is characterized by symptoms such as repetitive vomiting, pallor, diarrhea, and, in severe cases, hypovolemic shock following ingestion of the allergen food. To date, the only traditional treatment is strictly eliminating allergens in food. However, unlike prolonged elimination strategies, applying a food ladder (milk ladder) approach, commonly used in IgE-mediated food allergies, may facilitate earlier tolerance acquisition in selected FPIES cases.</p><p><strong>Case presentation: </strong>A 5-month-old female infant presented with projectile vomiting, coughing, fatigue, and subsequent diarrhea approximately 2 hours after consuming yoghurt. The presence of projectile vomiting, lethargy, and diarrhea prompted a preliminary diagnosis of non-IgE-mediated FPIES. In contrast, the combination of vomiting and coughing raised clinical suspicion of IgE-mediated anaphylaxis, which is defined as IgE-mediated. Following comprehensive clinical and laboratory evaluation, a diagnostic oral food challenge (OFC) confirmed a diagnosis of acute, early-onset, severe, and atypical FPIES triggered by milk protein. After maintaining a strict milk protein elimination diet for over 1 year, two separate OFCs with unprocessed milk were conducted to assess the development of tolerance, both of which yielded adverse outcomes that were related to FPIES. Subsequently, a stepwise reintroduction protocol based on the food ladder (milk ladder), consisting of milk products processed at varying degrees, including extensively baked, fermented, and eventually unprocessed forms, was implemented, resulting in the successful acquisition of tolerance (cake, yoghurt, milk, respectively).</p><p><strong>Conclusion: </strong>In IgE-mediated food allergies, the food ladder (milk ladder) is a well-established approach to induce tolerance. Although FPIES represents a non-IgE-mediated hypersensitivity, current evidence supporting such stepwise reintroduction strategies in this context remains limited. Prolonged and unnecessary elimination of allergen foods can have significant repercussions on the child's nutritional status and the family's psychosocial well-being, ultimately impairing quality of life. Our case highlights the potential utility of the food ladder (milk ladder) as an effective strategy for achieving tolerance in patients with non-IgE-mediated FPIES, offering an alternative to unnecessarily prolonged food restrictions.</p>","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692266","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":"Angelman Syndrome: Multidisciplinary Management.","authors":"Whitney A Bridges, Heide S Temples, Tracy B Lowe","doi":"10.1016/j.pedhc.2025.06.005","DOIUrl":"https://doi.org/10.1016/j.pedhc.2025.06.005","url":null,"abstract":"<p><p>Angelman syndrome is a rare genetic disorder with various phenotypes caused by the combination of genomic imprinting and loss of the maternal UBE3A gene. The case presentation involves a nine-month-old who continues with developmental delays after working with an early intervention therapist and was later diagnosed with Angelman syndrome following several specialty referrals and genetic testing. Currently, there is no cure for Angelman syndrome, only supportive symptomatic treatment. Angelman syndrome requires a multidisciplinary approach across providers who understand the complex care essential for these patients to thrive. The case study reviews the clinical presentation for early identification of infants with Angelman Syndrome, the diagnostic criteria, symptomatic management, family resources, implications for the primary care provider, and promising future therapies.</p>","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610226","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":"Unlocking the Potential of Social Robot Pepper: A Comprehensive Evaluation of Child-Robot Interaction","authors":"Alina Roštšinskaja MD,&nbsp;Marianne Saard PhD,&nbsp;Liisa Korts MSc,&nbsp;Christen Kööp MD,&nbsp;Kätlin Kits,&nbsp;Triinu-Liis Loit,&nbsp;Johanna Juhkami,&nbsp;Anneli Kolk MD, PhD","doi":"10.1016/j.pedhc.2025.01.010","DOIUrl":"10.1016/j.pedhc.2025.01.010","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to examine the child-robot interaction characteristics relevant to the use of robot Pepper as a new tool in neurorehabilitation.</div></div><div><h3>Method</h3><div>The study was conducted at the Children's Clinic of Tartu University Hospital and involved 89 children (aged 4–16 years): 39 healthy children and 50 children with neurological disorders. Forty-nine children interacted with Pepper directly, whereas 40 interacted via video. Interaction was assessed through therapists’ observations, self-ratings, and a survey based on four sociocultural concepts.</div></div><div><h3>Results</h3><div>Children quickly engaged with Pepper (M = 2.0 s), and 93.8% maintained eye contact throughout the entire interaction. The children found the robot friendly, thoughtful, intelligent, and safe. Children with neurological disorders perceived Pepper as twice as safe and more anthropomorphic. Communication via video showed less gesticulation and more static postures compared with those of direct interaction (55.9% vs. 80%, respectively).</div></div><div><h3>Discussion</h3><div>Pepper's anthropomorphic design enhances acceptance and is a potential tool for developing children's social skills.</div></div>","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":"39 4","pages":"Pages 572-584"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606978","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}