Journal of Pediatrics最新文献

{"title":"Duration of Antibiotic Therapy for Gram-Negative Bloodstream Infections in the Neonatal Intensive Care Unit","authors":"Colleen J. Djordjevich PharmD, BCPPS ,&nbsp;Jacqueline Magers PharmD, BCPS ,&nbsp;Joseph B. Cantey MD, MPH ,&nbsp;Pavel Prusakov PharmD, BCPPS, BCIDP ,&nbsp;Pablo J. Sánchez MD","doi":"10.1016/j.jpeds.2026.114993","DOIUrl":"10.1016/j.jpeds.2026.114993","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effectiveness and safety of short (≤8 days) vs long (≥9 days) duration of antibiotic therapy for uncomplicated gram-negative (GN) bloodstream infections (BSI) among infants in the neonatal intensive care unit (NICU).</div></div><div><h3>Study design</h3><div>Retrospective analysis of infants treated for GN BSI at 7 NICUs within 2 health care systems. Infants were identified by review of positive blood cultures from the microbiology laboratory and electronic health records. Patients were excluded if they had polymicrobial BSI, meningitis/osteomyelitis/endocarditis, or died before completion of therapy as ordered. The primary outcome was recurrence of BSI with the same organism within 14 days of discontinuation of effective antimicrobial therapy (“treatment failure.”) Secondary outcomes were emergence of GN multidrug-resistant organisms (MDRO) and mortality.</div></div><div><h3>Results</h3><div>In all, 76 infants (39 short duration; 37 long duration) were included; 15 (38%) and 25 (69%) infants had a central venous catheter in place at onset of BSI in the short and long duration groups, respectively. <em>Escherichia coli</em> was the most common pathogen in both groups (27 [69%], short duration; 18 [49%], long duration). There were 2 recurrences of BSI, both in the long duration group. Among study infants, 5 had a subsequent GN MDRO infection; all were in the long duration group.</div></div><div><h3>Conclusions</h3><div>Treatment failure and GN MDROs occurred among infants who received ≥9 days of antibiotic therapy. Shorter antibiotic duration (≤8 days) appeared to be an effective intervention that could reduce antibiotic exposure and its adverse consequences among NICU infants.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"292 ","pages":"Article 114993"},"PeriodicalIF":3.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004565","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":"Repetitive Motor Behaviors in Non-Autistic Toddlers","authors":"Monique Moore Hill MA ,&nbsp;Devon Gangi PhD ,&nbsp;Shy Maqbool BS ,&nbsp;Rachel Ni MS ,&nbsp;Chandni Parikh PhD ,&nbsp;Sally Ozonoff PhD","doi":"10.1016/j.jpeds.2026.114994","DOIUrl":"10.1016/j.jpeds.2026.114994","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate repetitive motor behaviors (RMBs) in non-autistic toddlers using direct observational methods.</div></div><div><h3>Study design</h3><div>This cohort study assessed RMBs in a community sample of 679 toddlers at 24 and 36 months of age. Initial analyses examined rates of RMBs in autistic (n = 65) vs nonautistic (n = 614) participants. Subsequent analyses focused on participants without autism, first examining clinical correlates of RMBs in the full non-autistic group and then comparing rates of RMBs in 2 non-autistic subgroups: 104 participants with other developmental concerns (ODC) and 510 participants with no developmental concerns.</div></div><div><h3>Results</h3><div>A total of 36% of non-autistic children demonstrated RMB at 24 and/or 36 months of age. RMBs were significantly more likely in the ODC (55%) than the no developmental concerns (33%) group. Non-autistic participants with RMBs had significantly lower communication scores at 24 months and, at both ages, significantly higher scores on 2 measures of autism-related symptomatology than those without RMBs; however, group means fell within the average range and effect sizes were small. There were no RMB differences based on sex.</div></div><div><h3>Conclusions</h3><div>RMBs are not uncommon in 24- to 36-month-old children who do not meet diagnostic criteria for autism. Among non-autistic children, RMBs are most likely to occur in those with other developmental challenges but are also present in some typically developing children. The presence of RMBs in toddlers should be evaluated within the context of Diagnostic and Statistical Manual of Mental Disorders, fifth edition ASD criteria, and RMBs alone without social communication challenges core to ASD should not be viewed as automatically indicative of autism.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"292 ","pages":"Article 114994"},"PeriodicalIF":3.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004520","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":"Echocardiography Has Become a Central Tool in Modern Congenital Diaphragmatic Hernia","authors":"Alexandre Lapillonne MD, PhD,&nbsp;Kelly Mellul MD,&nbsp;Elsa Kermorvant-Duchemin MD, PhD","doi":"10.1016/j.jpeds.2026.115008","DOIUrl":"10.1016/j.jpeds.2026.115008","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"292 ","pages":"Article 115008"},"PeriodicalIF":3.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042251","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":"Risk of Measles Vaccine Associated Febrile Seizures among Children 6-59 Months Old in a Federally Qualified Health System, 2008-2024","authors":"Kate Kurlandsky ScM ,&nbsp;Kristin Breslin MPH ,&nbsp;Amy Stein PhD ,&nbsp;Misha Brtnikova PhD, MPH ,&nbsp;Hannah Cruz MPH ,&nbsp;Joshua T.B. Williams MD","doi":"10.1016/j.jpeds.2026.115009","DOIUrl":"10.1016/j.jpeds.2026.115009","url":null,"abstract":"<div><div>A 15-year retrospective cohort study of 53 830 children 6-59 months old in a Federally Qualified Health System identified 10 febrile seizures 7-14 days after measles vaccination (incidence rate 2.05 [95% CI 0.98, 3.77] per 100 000 person-days); all had concurrent illnesses and co-administered vaccines. To date, no child has developed epilepsy.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"292 ","pages":"Article 115009"},"PeriodicalIF":3.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047446","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/S0022-3476(26)00125-3","DOIUrl":"10.1016/S0022-3476(26)00125-3","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"292 ","pages":"Article 115097"},"PeriodicalIF":3.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147797972","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":"Body Composition Tools in Young Children: A Spanner in the Works?","authors":"Jaz Lyons-Reid, José G B Derraik, Benjamin B Albert, Timothy Kenealy, Wayne S Cutfield","doi":"10.1016/j.jpeds.2026.115133","DOIUrl":"https://doi.org/10.1016/j.jpeds.2026.115133","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"115133"},"PeriodicalIF":3.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823694","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":"Nationwide Evidence on Rotavirus Vaccination and Celiac Disease: Strengths and Remaining Gaps.","authors":"Fernanda Cristofori, Stefania Castellaneta, Vanessa Nadia Dargenio, Ruggiero Francavilla","doi":"10.1016/j.jpeds.2026.115134","DOIUrl":"https://doi.org/10.1016/j.jpeds.2026.115134","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"115134"},"PeriodicalIF":3.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823646","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":"Between Machines and Mortality.","authors":"Idan Yoel","doi":"10.1016/j.jpeds.2026.115132","DOIUrl":"https://doi.org/10.1016/j.jpeds.2026.115132","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"115132"},"PeriodicalIF":3.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823662","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":"The Effect of Preterm Birth on Physical Activity for 9-12-Year-Old Children.","authors":"Kate L Cameron, Cassidy Du Berry, Maria Angel, Joy E Olsen, Melissa Middleton, Ross A Clark, Liam Welsh, Jeanie L Y Cheong, Alicia J Spittle, Tara L FitzGerald","doi":"10.1016/j.jpeds.2026.115115","DOIUrl":"https://doi.org/10.1016/j.jpeds.2026.115115","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the effect of preterm birth on physical activity (PA) in 9-12-year-old children, and to describe group differences in relationships between PA and lung function, and PA and respiratory morbidity, between children born preterm and term.</p><p><strong>Study design: </strong>343 children completed follow-up including children born very preterm (VPT; <30 weeks of gestation, n=91), moderate-late preterm (MLPT; 32-36 weeks of gestation, n=139) and term (n=117). PA was measured using 7-day accelerometry and the Physical Activity Questionnaire for Older Children (PAQ-C). Imputation models were used to handle missing data as the total sample recruited at birth included 551 participants.</p><p><strong>Results: </strong>Children born VPT had more stationary (mean difference (MD): 32 minutes, 95% CI 4, 60; p=0.024) and screen time (MD: 25 minutes, 95% CI 0.2, 50; p=0.048), and had lower PAQ-C scores (MD: -0.3, 95% CI -0.4, -0.1; p=0.001) than term-born children. Children born MLPT completed more screen time (MD: 22 minutes, 95% CI 1, 43; p=0.038) than term-born children. All children failed to meet moderate-vigorous PA recommendations (≥60 minutes/day), with 16.6 minutes on average observed across all participants.</p><p><strong>Conclusions: </strong>Children born VPT were more sedentary with lower PAQ-C scores, and both preterm groups (VPT and MLP) had higher screen time than children born at term. No children met moderate-vigorous PA guidelines, indicating early, targeted strategies to curb sedentary behavior and promote activity should be prioritized.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"115115"},"PeriodicalIF":3.5,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789576","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":"Examining Racial and Ethnic Differences in Referral and Management of Central Precocious Puberty in a Pediatric Endocrinology Clinic.","authors":"Chineze Ebo, Gajanthan Muthuvel, Jordyn McCray, Stephanie Penix, Lindsey Hornung, Nana-Hawa Yayah Jones, Iris Gutmark-Little","doi":"10.1016/j.jpeds.2026.115116","DOIUrl":"https://doi.org/10.1016/j.jpeds.2026.115116","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate racial and ethnic differences in referral timing, diagnostic evaluation, and treatment of central precocious puberty (CPP) among girls referred to a pediatric endocrinology clinic.</p><p><strong>Study design: </strong>Retrospective chart review of female patients referred for early puberty between January 2010 and January 2023 and subsequently diagnosed with CPP. Extracted data included age at referral, race and ethnicity, insurance type, pubertal stage at first visit, laboratory evaluation, imaging, and treatment. Patients with alternative diagnoses, those referred for other endocrine concerns, or those transferring care with a prior CPP diagnosis were excluded. Statistical analyses were performed using SAS® 9.4.</p><p><strong>Results: </strong>Of 485 referred patients, 259 met inclusion criteria. Referral age did not differ significantly across racial and ethnic groups (P= 0.08), nor did age at endocrinology appointment (P= 0.17). Median time from referral to appointment differed across racial and ethnic groups (P= 0.04), although absolute differences were small. Tanner staging at presentation did not significantly differ (breast stage P= 0.10; pubic hair stage P= 0.09). Diagnostic evaluation, including laboratory testing and imaging, was similar by race and ethnicity. GnRH agonists were prescribed to 44-71% of patients across racial groups without significant difference (P= 0.40), and time from first endocrinology visit to treatment initiation did not differ (P= 0.13). However, cumulative time from referral to treatment initiation differed by race and ethnicity (P= 0.01). Analyses stratified by insurance type and neighborhood deprivation index showed no significant differences in referral timing, evaluation, or treatment.</p><p><strong>Conclusions: </strong>We found no significant racial or ethnic disparities in CPP referral timing, evaluation, or treatment. A small difference in referral-to-appointment time was identified but is likely not clinically meaningful. Further research is needed to determine whether disparities in CPP recognition or referral patterns exist upstream from specialty care.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"115116"},"PeriodicalIF":3.5,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789591","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}