Journal of Pediatric Health Care最新文献

{"title":"Neonatal and Infant Health Outcomes Following Maternal COVID-19 Vaccination: CDC's COVID-19 Vaccine Pregnancy Registry.","authors":"Lauren Head Zauche, Sabrina A Madni, David K Shay, Christine K Olson, Erin Stroud, Andrea J Sharma","doi":"10.1016/j.pedhc.2026.06.017","DOIUrl":"10.1016/j.pedhc.2026.06.017","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 Vaccine Pregnancy Registry (C19VPR) monitored pregnant women vaccinated for COVID-19 during December 2020 to June 2021. We report incidence of health outcomes among infants of C19VPR participants.</p><p><strong>Methods: </strong>Data about birthweight (e.g., low birthweight [LBW] <2,500 grams), small-for-gestational-age (SGA), death, and 10 prespecified conditions (i.e., cardiac arrest, cardiomyopathy, congenital hearing loss, heart failure, hypoxic-ischemic encephalopathy, intussusception, myocarditis/pericarditis, seizures, stroke, and supraventricular tachycardia) were collected through phone interviews from birth through 3 months postpartum; among a subsample, interviews extended through 15 months postpartum. Incidence of each prespecified condition was compared with prepandemic estimates.</p><p><strong>Results: </strong>Of 19,852 infants with 3-month follow-up data, 125 (0.6%) had at least one prespecified condition. Estimated C19VPR incidences for these conditions, LBW, SGA, and death, were within or below ranges reported in prepandemic studies.</p><p><strong>Conclusion: </strong>The incidence of LBW, SGA, death, or each of 10 prespecified infant conditions in C19VPR did not exceed prepandemic estimates.</p>","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Study on Bronchiolitis Management: Quality Improvement, Guideline Utilization, and Resource Stewardship in the Pediatric Emergency Department.","authors":"Sarah Smith, Christy A Leyland, Margaret MacKay, Matthew K Icard, Rémi Hueckel","doi":"10.1016/j.pedhc.2026.06.011","DOIUrl":"https://doi.org/10.1016/j.pedhc.2026.06.011","url":null,"abstract":"","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473383","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 Key to Early Diagnosis: Retropharyngeal Abscess Masked by Neck Extension Limitation in a Pediatric Patient.","authors":"Ayfer Şahin, Meryem Coşkun","doi":"10.1016/j.pedhc.2026.06.013","DOIUrl":"https://doi.org/10.1016/j.pedhc.2026.06.013","url":null,"abstract":"<p><p>Retropharyngeal abscess (RFA) is a rare but potentially life-threatening deep neck infection in children and may lead to airway obstruction, mediastinitis, vascular complications, and other severe outcomes. In the pediatric population, RFA typically develops as a result of lymph node suppuration in this region secondary to an upper respiratory tract infection. We present the case of an 8-year-old boy who presented to the pediatric emergency department with sore throat, dysphagia, and nasal congestion. Because restricted neck extension raised suspicion for a deep neck infection, the patient was referred for otolaryngologic evaluation. The diagnosis of RFA was established based on characteristic findings on computed tomography, supported by the laboratory results. The patient was admitted to the hospital for treatment and was discharged after receiving parenteral antibiotic therapy. This case highlights the importance of careful head and neck examination, prompt recognition of restricted neck movement, and timely imaging in children with subtle upper respiratory tract symptoms.</p>","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473833","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":"Perianal Streptococcal Dermatitis in a Toddler: A Case Report.","authors":"Rachel Summo, Nancy Tosone","doi":"10.1016/j.pedhc.2026.06.006","DOIUrl":"https://doi.org/10.1016/j.pedhc.2026.06.006","url":null,"abstract":"<p><p>Perianal streptococcal dermatitis (PSD) is an underrecognized pediatric infection that is commonly misdiagnosed as other forms of dermatitis, leading to delayed diagnosis, prolonged symptoms, and risk of recurrence. This case report follows a 2-year-old male who presented to the clinic with a 2-month history of a persistent, bright red perianal rash associated with intense pruritus and painful defecation. The rash was unresponsive to topical corticosteroids, antifungals, and barrier creams. A perianal rapid antigen detection test confirmed Group A streptococcus infection. The patient was treated appropriately for PSD, with marked improvement of the rash within 72 hours and complete resolution at the 2-week follow-up. This case report highlights the importance of early recognition of characteristic features of PSD, prompt diagnostic testing, and initiation of antibiotic therapy to prevent treatment delay and recurrence.</p>","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425974","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 Fluoride Varnish Application into Primary Care Clinical Practice.","authors":"Shawn Cecil, Robert Wright, Sara Phillips, Grace Kyllo, Randi Henderson-Mitchell","doi":"10.1016/j.pedhc.2026.06.005","DOIUrl":"https://doi.org/10.1016/j.pedhc.2026.06.005","url":null,"abstract":"<p><strong>Introduction: </strong>The American Academy of Pediatrics (AAP) has recommended starting fluoride varnish applications to childen as early as 6 months of age, positioning pediatric primary care providers as a source of preventive care for dental caries, which impact more than half of children under age 5 years of age.</p><p><strong>Methods: </strong>A retrospective chart review of patients in our pediatric primary care clinic was undertaken to determine the impact of fluoride varnish applications on dental caries in children aged <5 years of age.</p><p><strong>Results: </strong>Since November 2021, there have been 1,916 fluoride applications in the clinic. Of those children who received at least one fluoride application, 96.8% did not go on to have dental caries, whereas 100% with ≥ 3 applications did not develop cavities.</p><p><strong>Discussion: </strong>Implementing new primary care practice habits can be very difficult. While no statistical decrease in dental caries has been observed since implementing fluoride varnish, we observed a dose-dependent relationship between fluoride varnish and dental caries.</p>","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370555","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":"Fever in Acute Post-Streptococcal Glomerulonephritis: Prevalence and Clinical Significance","authors":"Shiri Curelaru MD,&nbsp;Elina Gelman MD,&nbsp;Asaf Lebel MD","doi":"10.1016/j.pedhc.2025.09.002","DOIUrl":"10.1016/j.pedhc.2025.09.002","url":null,"abstract":"<div><h3>Purpose</h3><div>Acute post-streptococcal glomerulonephritis (APSGN) is a common cause of glomerulonephritis in children following infection with group A β-hemolytic streptococcus (GAS). Fever has been uncommonly reported in APSGN, and its clinical significance has not been assessed. Fever and elevated inflammation markers might be related to altered kidney outcomes. This study aimed to evaluate the prevalence and significance of fever among pediatric patients with APSGN.</div></div><div><h3>Methods</h3><div>We performed a single-center retrospective analysis of patients diagnosed with APSGN from 2005 to 2024. Inclusion criteria encompassed clinical signs of glomerulonephritis, low serum C3 levels, and evidence of GAS infection. We compared short- and medium-term kidney outcomes, including estimated glomerular filtration rate, blood pressure, hematuria, and proteinuria between febrile and afebrile patients.</div></div><div><h3>Results</h3><div>Of the 69 eligible patients with APSGN, 24 (34.8%) presented with fever. Febrile patients exhibited symptoms of infection, mostly viral diseases, had higher C-reactive protein levels, and experienced prolonged hospital stay compared to afebrile patients. However, there were no significant differences between the groups in the severity of glomerulonephritis or medium-term kidney outcomes.</div></div><div><h3>Conclusions</h3><div>Fever is a common presenting symptom in pediatric patients with APSGN. It is associated with prolonged hospital stay and higher serum inflammation markers, but is not significantly associated with a worse short- or medium-term kidney prognosis.</div></div><div><h3>Summary at a Glance</h3><div>Fever is a frequent presenting symptom in pediatric patients with acute post-streptococcal glomerulonephritis (APSGN). Although it is associated with prolonged hospitalization and increased C-reactive protein levels, it does not alter short or medium-term outcomes.</div></div>","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":"40 4","pages":"Pages 603-607"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253423","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 an Evidence-Based Neonatal Circumcision Pain Management Protocol: A Quality Improvement Initiative","authors":"Renu Mathews Philip DNP, APRN, CPNP, EBP-C,&nbsp;Francisco Ayala DNP, APRN, FNP-C, EBP-C,&nbsp;Jennifer Wilson DNP, RN, CPN, EBP-C","doi":"10.1016/j.pedhc.2025.11.007","DOIUrl":"10.1016/j.pedhc.2025.11.007","url":null,"abstract":"<div><h3>Background</h3><div>A lack of standardized neonatal circumcision pain management guidelines leads to inconsistencies across pediatric settings and poor outcomes, such as feeding and sleep disturbances, which can increase costs, lead to longer hospital stays, or require closer observation outside of parents’ presence. Nurse practitioners (NP) are well-equipped to lead evidence-based quality improvement (QI) initiatives.</div></div><div><h3>Aim</h3><div>To evaluate an evidence-based neonatal circumcision pain protocol across the care continuum from preprocedural to recovery.</div></div><div><h3>Methods</h3><div>The Knowledge-to-Action framework and QI methodologies guided the initiative and evaluation of the new protocol’s impact on neonates’ pain scores and sustainability.</div></div><div><h3>Intervention</h3><div>Acetaminophen pre-circumcision, white noise procedural, standardized pain assessment, and acetaminophen or nonpharmacologic measures during recovery.</div></div><div><h3>Results</h3><div>Neonates’ pain scores significantly decreased from 3.14 to 1.12 (<em>p</em> &lt;.001) after implementation, which relied on provider compliance. Process aims were achieved in Plan-Do-Study-Act cycle 3 and sustained; 100% of providers agreed that the new protocol improved neonatal pain management.</div></div><div><h3>Conclusions</h3><div>Effective circumcision pain management relies on a comprehensive approach. This QI initiative highlights NP leadership in driving evidence-based change.</div></div>","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":"40 4","pages":"Pages e163-e171"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670638","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":"Activate. Align. Amplify.: A Presidential Vision for Pediatric Advanced Practice Nursing Leadership","authors":"Nutrena H. Tate PhD, MBA, APRN, CPNP-PC, NEA-BC, FADLN","doi":"10.1016/j.pedhc.2026.04.002","DOIUrl":"10.1016/j.pedhc.2026.04.002","url":null,"abstract":"","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":"40 4","pages":"Pages 483-484"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363281","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":"Educational Strategy to Increase Nursing Student Knowledge, Attitudes and Clinical Preparedness when Caring for LGBTQIA+ Individuals","authors":"Brenda Cassidy DNP, RN, CPNP-PC, Associate Professor Emeritus,&nbsp;Betty Braxter PhD, RN, CNM, FAAN, Associate Dean for Undergraduate Education,&nbsp;Brayden Kameg PhD, DNP, PMHNP-BC, CARN-AP, CNE, FIAAN, Associate Dean of Graduate Clinical Education,&nbsp;Zhirui Deng MS, Statistician,&nbsp;Todd Tartavoulle DNS, APRN, CNS-BC,&nbsp;Alison Davis PhD, RN, CNE, CHSE","doi":"10.1016/j.pedhc.2026.05.007","DOIUrl":"10.1016/j.pedhc.2026.05.007","url":null,"abstract":"<div><h3>Category/Date</h3><div>Research &amp; Scholarship Podium Presentations: <strong><em>Addressing Diverse Pediatric Populations.</em></strong> Presented at NAPNAP’s 47^th National Conference on Pediatric Health Care, March 19, 2026.</div></div><div><h3>Background</h3><div>Delivering culturally competent care to underrepresented groups is essential to addressing health disparities among vulnerable populations. The LGBTQIA+ community continues to face health inequities due to stigmatization and discrimination. LGBTQIA+ youth are 34% more likely to experience bullying or physical violence, and 29% are more likely to attempt suicide, compared to just 6% of their heterosexual peers. Additionally, young gay and bisexual men represent 8 out of 10 new HIV diagnoses in the U.S. Lack of standardized curricular guidelines for LGBTQIA+ health in nursing education contributes to gaps in preparing healthcare providers to deliver inclusive and affirming care for youth.</div></div><div><h3>Purpose</h3><div>The University of Pittsburgh and Louisiana State University Health New Orleans collaborated to implement an innovative educational strategy using a scaffolded approach across 4-year BSN curricula. The goal of this IRB approved study was to integrate LGBTQIA+ health into the undergraduate curriculum and expand to graduate curriculum, supporting the delivery of culturally competent inclusive care for all individuals.</div></div><div><h3>Design</h3><div>A pre-post longitudinal design used the validated LGBT-DOCSS tool to assess changes in nursing students' knowledge, attitudes, and clinical preparedness over time. Upon receiving IRB exempt status approval from both Universities, a convenience sample was recruited preceding enrollment in clinical courses. Prior to participation, students reviewed an information sheet and provided implicit consent by accessing the baseline survey. An introductory module followed by advocacy training and exposure to virtual simulation formed the study’s protocol.</div></div><div><h3>Results</h3><div>The sample was typically white heterosexual females. Significant improvements were found across Knowledge (p &lt; .001), Attitudes (p = .0038), Clinical Preparedness (p &lt; .001), and Overall scores (p &lt; .001).</div></div><div><h3>Conclusion</h3><div>This study supports health equity and addresses disparities found with gender diverse youth. Including evidence-based LGBTQIA+ education in pediatric-focused advance practice provider curricula has the potential to improve health outcomes for this vulnerable population.</div></div><div><h3>IRB Approval</h3><div>Exempt status from both Universities Funding from the University of Pittsburgh School of Nursing Health Promotion and Development Department for statistician support</div></div>","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":"40 4","pages":"Pages 637-638"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148530110","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":"Position Statement Regarding the Use and Exposure to Tobacco and Nicotine Products in Children, Adolescents, and Young Adults","authors":"","doi":"10.1016/j.pedhc.2026.03.002","DOIUrl":"10.1016/j.pedhc.2026.03.002","url":null,"abstract":"","PeriodicalId":50094,"journal":{"name":"Journal of Pediatric Health Care","volume":"40 4","pages":"Pages 630-633"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148530113","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}