Journal of pediatrics. Clinical practice最新文献

{"title":"Optimizing Outcomes from Childhood into Adulthood: Prevalence of Social Needs in Pediatric Cardiology.","authors":"Hemen Muleta, Kevin P Fiori","doi":"10.1016/j.jpedcp.2025.200148","DOIUrl":"10.1016/j.jpedcp.2025.200148","url":null,"abstract":"","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"16 ","pages":"200148"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12166746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief Report: Trends of Congenital Syphilis among Neonates in Canada 2012-2023.","authors":"Chantal R M Nelson, Annalise Ferro, Katarzyna Naczk, Ari Bitnun, Deborah Money, Micheal Narvey, Genevieve Gravel, Joanna Merckx, Michiel Van den Hof, Heather Scott, Leah Thorp, Elisabeth McClymont, Prakesh S Shah","doi":"10.1016/j.jpedcp.2025.200146","DOIUrl":"10.1016/j.jpedcp.2025.200146","url":null,"abstract":"<p><p>In Canada, incidence of congenital syphilis significantly increased from 2018 to 2023. Supporting enhanced public health preventive interventions such as early screening and treatment, particularly for younger women in lower socioeconomic strata and those with a history of addictive substance use, may reduce congenital syphilis.</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"16 ","pages":"200146"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Electronic, Preclinic, Social Determinants Survey Shows Pediatric Atherosclerotic Risk Factor Referral Identifies At-Risk Families.","authors":"Justin R Rahman, Bethany S Zachariah, Christina Y Miyake, Deidra Ansah, Justin P Zachariah","doi":"10.1016/j.jpedcp.2025.200145","DOIUrl":"10.1016/j.jpedcp.2025.200145","url":null,"abstract":"<p><strong>Objective: </strong>Atherosclerotic risk factors are prevalent in childhood. Risk factors are associated with social determinants of health (SDoH), but have never been demonstrated in a clinical pediatric cardiology cohort. This report details the first use of a remotely deployed, previsit, self-administered electronic survey for the ascertainment of SDoH in youth referred to pediatric cardiology. We hypothesized that patients referred for atherosclerotic risk factors would have higher risk of SDoH factors.</p><p><strong>Study design: </strong>SDoH were assessed using validated instruments from the PRAPARE toolkit and the Accountable Health Communities Health-Related Social Needs Screening Tool automatically deployed days before a scheduled visit in a HIPAA compliant email link to patients. Hypertension, Lipid, and Electrophysiology referral visits were compared to referent General cardiology referral visits using generalized estimating equations to account for repeat visits.</p><p><strong>Results: </strong>Response rates were similar in each clinic, ranging from 17 to 22%. Compared to General Cardiology (n = 3543 visits), Hypertension referral (n = 1143) was significantly associated with having any SDoH problem (9.3% vs 22%), specifically being concerned about (6.3% vs 15.3%) or actual food insecurity (4.4% vs 12%), and lacking transportation to medical care (0.8% vs 5.3%). Lipid referral (n = 2344) was also associated with being concerned about (6.3% vs 10.2%) or actually food insecure (4.4% vs 8.5%), lacking transport to medical care (0.8% vs 2.6%), and inability to pay for utilities (1.2% vs 3.1%).</p><p><strong>Conclusions: </strong>Families with youth referred for atherosclerotic risk factors were at higher risk of food insecurity, transportation obstacles to medical visits, and obtaining utilities.</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"16 ","pages":"200145"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Frequency and Yield of Echocardiography in a Pediatric Intensive Care Unit.","authors":"Shafee Salloum, Andrew J Lautz, Christopher Statile","doi":"10.1016/j.jpedcp.2025.200143","DOIUrl":"10.1016/j.jpedcp.2025.200143","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the frequency and diagnostic yield of transthoracic echocardiography (TTE) in a noncardiac pediatric intensive care unit (PICU).</p><p><strong>Study design: </strong>This was a single-center retrospective observational study of a 48-bed quaternary-care PICU. Patients younger than 18 years who had a TTE performed during their PICU stay from February 3, 2015, to December 8, 2022, were included, and patients on extracorporeal membrane oxygenation support were excluded.</p><p><strong>Results: </strong>We analyzed 2633 TTEs from 1445 patients, with only the first study included for patients with multiple TTEs. The median age of all patients was 4.4 years (IQR 1-12.4 years). Low ventricular function, defined as moderate or severe systolic dysfunction, was found in 6% of all TTEs, whereas 94% showed hyperdynamic, normal, or mildly diminished ventricular function. TTEs were classified into 25 categories on the basis of indications. Low ventricular function was present in 10% of shock cases, 17% of cardiac arrests, and 2% of respiratory failures. Among cases of respiratory failure, 88% showed no pulmonary hypertension. A low yield group, comprising 16% of total first TTEs, included acute respiratory failure, persistent tachycardia, abnormal electrocardiograms, and systemic hypertension. Among those evaluated for pulmonary hypertension, 62% showed no evidence of it, whereas 4% exhibited severe pulmonary hypertension, all with a pre-existing history. For pericardial effusion evaluation, 82% had no or trivial-small effusion.</p><p><strong>Conclusions: </strong>TTE frequently is used in the noncardiac PICU, but its diagnostic yield varies widely on the basis of clinical indications. This study emphasizes the need for careful use of TTE in the PICU, with consideration of pretest probability and clinical context to enhance diagnostic effectiveness in critically ill pediatric patients.</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"16 ","pages":"200143"},"PeriodicalIF":0.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent Bronchopulmonary Sequestration in Congenital Diaphragmatic Hernia: Is Frequency Increasing or Are We Better at Diagnosis?","authors":"Michelle J Yang, Christian C Yost, Martha Monson, Paula J Woodward, Anne M Kennedy, Stephen J Fenton, Katie W Russell, Janice L B Byrne, Bradley A Yoder","doi":"10.1016/j.jpedcp.2025.200141","DOIUrl":"10.1016/j.jpedcp.2025.200141","url":null,"abstract":"<p><strong>Objective: </strong>To assess the incidence and clinical outcomes of neonates with congenital diaphragmatic hernia with patients with concurrent bronchopulmonary sequestration (CDH + BPS).</p><p><strong>Study design: </strong>In this retrospective cohort study, we compared BPS diagnoses in patients with CDH across 4 epochs (2002-2008, 2009-2015, 2016-2019, 2020-2023) to assess incidence and outcomes of neonates with CDH + BPS. Because of marked epoch differences in key outcomes, we only compared extracorporeal membrane oxygenation use and survival for CDH + BPS and CDH alone across the final 2 epochs using multinominal regression analysis.</p><p><strong>Results: </strong>Among 383 neonates with CDH, we concurrently diagnosed 15 (3.9%) with BPS. Consistent with increasing fetal CDH diagnoses (56% in 2002-2008 vs 74% in 2020-2023; <i>P</i> < .05) and fetal magnetic resonance imaging (0% in 2002-2008 vs 92% in 2020-2023; <i>P</i> < .001), CDH + BPS rates increased from 1.9% across the first 3 epochs to 13.2% in the 2020-2023 epoch (<i>P</i> < .001). There were no differences in other anomalies, repair rates, thoracic liver, or defect size. From 2016 onward, all 10 neonates diagnosed with CDH + BPS survived without extracorporeal membrane oxygenation. CDH + BPS neonates had larger defects and increased rates of nonprimary repair. After we controlled for defect size, neonates with CDH + BPS had greater rates of vasodilator therapy for postoperative pulmonary hypertension (56% vs 23%; <i>P</i> < .05). However, there were no differences in home discharge on pulmonary vasodilator medications or oxygen.</p><p><strong>Conclusion: </strong>Incidence of CDH + BPS diagnoses increased over time with an increased need of inpatient vasodilatory therapy. Additional studies with enhanced imaging analyses and intraoperative assessment are needed to better define the incidence and potential impact of concurrent BPS on CDH morbidities and outcomes.</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"15 ","pages":"200141"},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aligning with Obesity Guidelines: A Quality Improvement Initiative in Pediatric Primary Care.","authors":"Alicia Tucker, Richard Fagbemigun, Christina Driskill, Nia Bodrick, Kaleab Ribbiso, Abraham Ipe, Meera Krishnamoorthy, Adwoa Bamfo, Kofi Essel","doi":"10.1016/j.jpedcp.2024.200135","DOIUrl":"10.1016/j.jpedcp.2024.200135","url":null,"abstract":"<p><strong>Objective: </strong>National guidelines recommend diagnosis of obesity on the basis of body mass index starting at age 2 years and screening for specific comorbidities based on age and risk factors. A multimodal intervention was developed and quality improvement (QI) methodology was used to assess the effectiveness of different interventions on pediatric primary care clinician's adherence to evidence-based clinical guidelines.</p><p><strong>Study design: </strong>A multidisciplinary team was engaged to develop an institutional weight management and diet-related disease toolkit to standardize practice through a QI initiative. This initiative included an educational series, coaching sessions for a subset of providers, and automating electronic medical record (EMR) changes to support adherence to the clinical toolkit. We staggered the interventions to assess for behavior change related to clinical documentation and laboratory test ordering practices.</p><p><strong>Results: </strong>Baseline data showed significant differences between individual clinicians' practices. Educational initiatives increased the use of diagnostic obesity codes from a baseline of <20% to >75% of charts. Initially, <i>International Classification of Diseases</i>, <i>Tenth Revision</i>, codes for nutrition and physical activity counseling were underused and remained low despite education interventions. EMR prompts and templates led to a significant and sustained increase in coding. A statistically significant decrease in overall extraneous laboratory test collection was noted but inconsistencies in laboratory test collection persisted.</p><p><strong>Conclusions: </strong>This QI initiative aimed to standardize clinicians' behavior around EMR documentation. A multimodal intervention was able to improve documentation of weight status and counseling measures to >80% of well child check encounters. Future studies are encouraged to investigate whether these changes led to improved patient outcomes.</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"14 ","pages":"200135"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11824626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Difficulty with Dental Caries among Adolescents Who Are Underweight: A Nationwide Study.","authors":"Vinodh Bhoopathi, Paula Ortega-Verdugo, Christine Wells, Honghu Liu","doi":"10.1016/j.jpedcp.2024.200136","DOIUrl":"10.1016/j.jpedcp.2024.200136","url":null,"abstract":"<p><p>This study highlights a unique association between weight status and difficulty with dental caries among US adolescents. Being underweight was significantly associated with dental caries in adolescents aged 10-17.</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"14 ","pages":"200136"},"PeriodicalIF":0.0,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Growth, Therapeutic Effectiveness, and Disparities in Pediatric Type 1 Diabetes: Lessons from Continuous Glucose Monitoring Use in Latin America.","authors":"Linda A DiMeglio, Adda Grimberg","doi":"10.1016/j.jpedcp.2024.200137","DOIUrl":"10.1016/j.jpedcp.2024.200137","url":null,"abstract":"","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"14 ","pages":"200137"},"PeriodicalIF":0.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Availability of Prescription Opioid Disposal Bins at United States Children's Hospitals.","authors":"Rabab M Barq, Laura Houshmand, Olivia A Keane, Shadassa Ourshalimian, Lorraine I Kelley-Quon","doi":"10.1016/j.jpedcp.2024.200133","DOIUrl":"10.1016/j.jpedcp.2024.200133","url":null,"abstract":"<p><p>This descriptive study examined availability of prescription opioid disposal bins at US children's hospitals and assessed pharmacy-provided information on safe disposal. Only 44.2% reported a bin on site and among those without, advice varied. These findings highlight the need for improved prescription opioid disposal education and infrastructure at children's hospitals.</p>","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"14 ","pages":"200133"},"PeriodicalIF":0.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Gold is Tarnished: The Impact of Smoker's Breast Milk on Offspring Growth.","authors":"Elizabeth Yen","doi":"10.1016/j.jpedcp.2024.200132","DOIUrl":"10.1016/j.jpedcp.2024.200132","url":null,"abstract":"","PeriodicalId":519930,"journal":{"name":"Journal of pediatrics. Clinical practice","volume":"14 ","pages":"200132"},"PeriodicalIF":0.0,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}