Journal of Pediatrics最新文献

{"title":"Primary Ciliary Dyskinesia and PI3K Delta Syndrome: More than Meets the Eye","authors":"Thomas R. Welch MD","doi":"10.1016/j.jpeds.2025.114570","DOIUrl":"10.1016/j.jpeds.2025.114570","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"280 ","pages":"Article 114570"},"PeriodicalIF":3.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information for Readers","authors":"","doi":"10.1016/j.jpeds.2025.114561","DOIUrl":"10.1016/j.jpeds.2025.114561","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"280 ","pages":"Article 114561"},"PeriodicalIF":3.9,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Population-Based Study of Rates of Invasive Bacterial Infection (IBI) and Missed IBI in Febrile Infants 8 to 90 Days of Age.","authors":"Jeffrey P Yaeger, Elaine L Hill, Ashkan Ertefaie, Kevin A Fiscella","doi":"10.1016/j.jpeds.2025.114578","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114578","url":null,"abstract":"<p><strong>Objectives: </strong>To establish population-based rates of invasive bacterial infection (IBI; bacteremia and/or bacterial meningitis) in febrile young infants, to compare demographic characteristics of febrile infants with IBIs with liveborn infants, to calculate performance of lumbar puncture and hospitalization proportions, and to estimate the proportion of missed IBI diagnoses.</p><p><strong>Study design: </strong>We used New York State's all-payer database to identify healthy, full-term, febrile infants aged 8 to 90 days of age who were evaluated for fever in emergency departments from 2012-2023. Using chi square statistics, we compared IBI rates and demographic characteristics of febrile infants with IBIs with the age-stratified population. We calculated age-stratified performance of lumbar puncture, hospitalization, and missed IBI proportions.</p><p><strong>Results: </strong>Of 2,295,788 healthy, full-term births, 66,692 infants were evaluated in EDs between 8 and 90 days of age with fever. The IBI rate was 5.3/1,000,000 infant-days and decreased significantly with advancing age to 90 days (p<.0001). Febrile infants with IBIs differed significantly by sex, type of insurance, race, ethnicity, and type of hospital ED (p<.00001). Lumbar puncture and hospitalization proportions decreased significantly (p<.0001) with advancing age whereas missed IBI proportions increased (p<.05). IBI rates did not change over the 12-year study period.</p><p><strong>Conclusions: </strong>Findings demonstrate a stepwise reduction in rates of IBIs and performance of lumbar puncture and hospitalization with advancing age to 90 days, coupled with an increase in proportions of missed IBIs. Significant demographic differences exist between febrile infants with IBIs and the population of age-matched infants. Strategies to reduce IBIs and missed IBIs in high-risk groups should be pursued.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114578"},"PeriodicalIF":3.9,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balancing Relief and Risk: The Potential Impact of Pediatric Opioid Prescriptions on Family Members.","authors":"Scott E Hadland, Jessica B Calihan","doi":"10.1016/j.jpeds.2025.114577","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114577","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114577"},"PeriodicalIF":3.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Antiviral Drug Use Among Commercially Insured Children at High Risk for Complications of Influenza","authors":"Abdullah Abdelaziz MS ,&nbsp;Jyotirmoy Sarker MPharm, MBiotech, MBA ,&nbsp;Pei-Wen Lien MS ,&nbsp;Derek J. Williams MD, MPH ,&nbsp;Carlos G. Grijalva MD, MPH ,&nbsp;Todd A. Lee PharmD, PhD ,&nbsp;James W. Antoon MD, PhD, MPH","doi":"10.1016/j.jpeds.2025.114574","DOIUrl":"10.1016/j.jpeds.2025.114574","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the prevalence of antiviral drug use in children in the US with influenza at high risk for complications and to identify factors associated with dispensing.</div></div><div><h3>Study design</h3><div>We conducted a retrospective cohort study of outpatient visits for individuals &lt; 18 years during the 2016-2020 influenza seasons using the Merative MarketScan Commercial Claims and Encounter database. High-risk status was defined using Infectious Disease Society of America definitions and included: age, specific comorbidities, pregnancy or postpartum status, and living in a long-term care facility. The primary outcome was antiviral (oseltamivir, zanamivir, baloxavir) dispensing within 2 days of influenza diagnosis. We determined clinical factors associated with antiviral dispensing using modified Poisson regression.</div></div><div><h3>Results</h3><div>A total of 372 372 influenza episodes were identified among 331 389 children at high risk for influenza complications and included in this study. The median (IQR) age was 4.0 years (2.0, 9.0). Overall, during 201 638 (54.1%) episodes of the influenza, antiviral treatment was dispensed. Factors associated with increased antiviral use included asthma, West and South US geographic regions, urgent care settings, and specific health insurance plans. Factors associated with decreased antiviral use include younger age, emergency department setting, Midwest and Northeast geographic regions, and health insurance plans.</div></div><div><h3>Conclusion</h3><div>Despite national guidelines recommending that all children at high risk for influenza complications receive antiviral treatment, nearly half of these children at high-risk did not receive an antiviral in our study. We identify several factors associated with decreased antiviral treatment that may serve to inform future interventions aiming to improve the care of vulnerable children with influenza.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"282 ","pages":"Article 114574"},"PeriodicalIF":3.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Prenatal Repair for Fetal Myelomeningocele on Gastrointestinal Function","authors":"Jessian L. Munoz MD, PhD, MPH ,&nbsp;Emma Kelling MPH ,&nbsp;Rebecca M. Johnson MS ,&nbsp;Cara Buskmiller MD, MS ,&nbsp;William E. Whitehead MD, MPH ,&nbsp;Luc Joyeux MD, PhD ,&nbsp;Roopali V. Donepudi MD ,&nbsp;Ahmed A. Nassr MD, PhD ,&nbsp;Michael A. Belfort MD, PhD ,&nbsp;Jonathan Castillo MD, MPH ,&nbsp;Heidi Castillo MD ,&nbsp;Magdalena Sanz Cortes MD, PhD","doi":"10.1016/j.jpeds.2025.114573","DOIUrl":"10.1016/j.jpeds.2025.114573","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the impact of postnatal, open fetal, and fetoscopic repairs for open neural tube defects (ONTDs) on bowel function and to assess the use of diet modification and medication use to achieve regular bowel function.</div></div><div><h3>Study design</h3><div>A retrospective cohort study was performed from 2011 to 2020 at our academic referral fetal center. Patients were stratified by route of surgery (postnatal, open prenatal, or fetoscopic prenatal). Bowel function was assessed by patient reported Bristol stool scale as well as a detailed review of current medication usage for bowel management. Patient demographics and clinically relevant outcomes were obtained from electronic medical records. The primary outcome was bowel function assessed at 30-month follow up visit.</div></div><div><h3>Results</h3><div>A total of 150 patients with fetal ONTD underwent repair at our institution. Forty-eight (32%) underwent postnatal repair, 34 (23%) open fetal surgery, and 68 (45%) fetoscopic repair. Eighty-six patients (57%) reported abnormal bowel function at 30 months of life. No differences were noted in abnormal bowel function between surgical approaches (postnatal 35% vs open prenatal 26%, and fetoscopic 49%, <em>P</em> = .08). Patients who underwent postnatal repair were more likely to require oral regimens to achieve normal bowel function compared with either prenatal surgery approach (postnatal 83% vs open prenatal 59%, and fetoscopic 69%, <em>P</em> = .046).</div></div><div><h3>Conclusion</h3><div>Abnormal bowel function remains a significant morbidity regardless of surgical approach for ONTD. Fetal surgery (open or fetoscopic) for ONTD may result in equivalent bowel function when compared with postnatal repair.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"282 ","pages":"Article 114573"},"PeriodicalIF":3.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Actionable Areas of Distress Among Pediatric Cardiology Fellows","authors":"Nikhil Rajapuram MD ,&nbsp;Megha D. Tandel MPH ,&nbsp;Daniel Tawfik MD, MS ,&nbsp;Yingjie Weng MHS ,&nbsp;Caroline E. Rassbach MD, MAEd ,&nbsp;Neha J. Purkey MD","doi":"10.1016/j.jpeds.2025.114572","DOIUrl":"10.1016/j.jpeds.2025.114572","url":null,"abstract":"<div><h3>Objective</h3><div>To quantify burnout and identify specific stressors among a national sample of pediatric cardiology fellows.</div></div><div><h3>Study design</h3><div>We invited program directors at all 61 Accreditation Council for Graduate Medical Education-accredited pediatric cardiology training programs to distribute a 40-item survey to their categorical (year 1-3) fellows from February to April 2023. The survey included the Stanford Professional Fulfillment Index and ratings of key stressors to understand levels of burnout and associated stressors.</div></div><div><h3>Results</h3><div>In total, 67% (261/391) of contacted pediatric cardiology fellows completed the survey, representing 50% of all categorical fellows in the US. Of these, 42% reported symptoms of burnout. Fellows without children were found to have increased odds of experiencing burnout symptoms compared with those with children (OR 2.03). 13 of 15 stressors were associated with increased burnout scores, of which “excessive number of work hours,” “challenges to prioritizing self-care,” and “mistreatment from supervisors” were the top 3.</div></div><div><h3>Conclusion</h3><div>This national study of pediatric cardiology fellows shows a high prevalence of burnout. The modifiable stressors identified in this study offer opportunities to improve the well-being of this group of trainees.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"282 ","pages":"Article 114572"},"PeriodicalIF":3.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of Rapid Whole Genome Sequencing in Pediatric Acute Care is Associated with Positive Shifts in Healthcare Professionals' Perspectives Toward Testing.","authors":"Andrea Scheurer-Monaghan, Joseph D Fakhoury, Caleb P Bupp, Melissa A Hicks, Danielle Nolan, Jessica Omark O'Shea, Thomas J Hoffmann, Renee Mehra, Linda S Franck","doi":"10.1016/j.jpeds.2025.114571","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114571","url":null,"abstract":"<p><p>Healthcare professional (HCP) attitudes were more positive after Project Baby Deer statewide collaborative implementation of rapid whole genome sequencing (rWGS) in inpatient pediatrics, and associated with greater rWGS exposure and knowledge. HCPs recommended improving equity and ease of access to rWGS, and tailored educational materials for clinical teams and families.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114571"},"PeriodicalIF":3.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a Two-Person Mask Ventilation Technique During Neonatal Resuscitation: A Simulation-Based Randomized Controlled Trial","authors":"Katharina Bibl MD ,&nbsp;Michael Wagner MD, PhD ,&nbsp;Robyn Dvorsky MD ,&nbsp;Moritz Haderer BSc ,&nbsp;Lena Strasser ,&nbsp;Angelika Berger MD ,&nbsp;Anne Ades MD, MEd ,&nbsp;Mark Castera MD ,&nbsp;Isabel T. Gross MD, PhD, MPH ,&nbsp;Akira Nishisaki MD, MSCE","doi":"10.1016/j.jpeds.2025.114568","DOIUrl":"10.1016/j.jpeds.2025.114568","url":null,"abstract":"<div><h3>Objective</h3><div>To assess whether the two-person ventilation technique during simulated neonatal resuscitation enables higher ventilation quality compared with the one-person technique, as measured by expiratory tidal volume (eV_T), mask leak, positive inspiratory pressure, respiratory rate, and minute ventilation.</div></div><div><h3>Study design</h3><div>We conducted a randomized, cross-over simulation trial including 74 neonatal care providers at the Neonatal Simulation Center, Children's Hospital of Philadelphia. Participants performed bag-mask ventilation using one-person and two-person techniques in a randomized order. Ventilation parameters were recorded using a respiratory function monitor. Visual attention was analyzed using eye-tracking technology. The primary outcome was the time to achieve effective ventilation defined by eV_T between 4-8 ml/kg and mask leak ≤30% for 10 consecutive seconds.</div></div><div><h3>Results</h3><div>No participant achieved the primary ventilation target in either technique. The two-person technique showed higher eV_T (9.7 mL/kg vs 8.4 mL/kg, absolute difference −1.3 mL/kg, 95% CI [-2.4, −0.1], <em>P</em> = .032) and a significant reduction in mask leak (48.9% vs 62.9%, absolute difference of 14.0%, 95% CI [6.4, 22.0], <em>P</em> &lt; .001). Eye-tracking indicated differing visual attention patterns between techniques, with the two-person technique focusing more on the mask and bag (dwell time: 25% one-person vs 34% two-person, <em>P</em> = .13).</div></div><div><h3>Conclusions</h3><div>The two-person ventilation technique was associated with increased eV_T and decreased mask leak during simulated neonatal resuscitation. Further research is needed to evaluate the impact of different ventilation devices and techniques in clinical settings.</div></div><div><h3>Clinical Trial Registration</h3><div>Since this was a simulation-based study, registration in a clinical trial registry was not required.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"282 ","pages":"Article 114568"},"PeriodicalIF":3.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous Nodules in an Infant from Uganda: A Rare, Vaccine-Associated Complication","authors":"Taylor Erickson MD,&nbsp;Anthony J. Mancini MD","doi":"10.1016/j.jpeds.2025.114565","DOIUrl":"10.1016/j.jpeds.2025.114565","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"282 ","pages":"Article 114565"},"PeriodicalIF":3.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}