Journal of Pediatrics最新文献_第3页

Integrated Care Model in Pediatrics: The Value of Children's Views and Self-Care. 儿科学综合护理模式：儿童观点与自我护理的价值。

IF 3.5 2区医学

Journal of Pediatrics Pub Date : 2025-09-24 DOI: 10.1016/j.jpeds.2025.114830

Sachi Takeuchi

引用次数: 0

Inpatient Symptom Prevalence, Severity, and Improvement in Children Referred for Pediatric Palliative Care Consultation: Findings from a Multisite Quality Improvement Registry. 转介小儿姑息治疗会诊的儿童的住院症状患病率、严重程度和改善：来自多站点质量改善登记的结果。

IF 3.5 2区医学

Journal of Pediatrics Pub Date : 2025-09-23 DOI: 10.1016/j.jpeds.2025.114828

Andrea C Postier, Maggie C Root, David L O'Riordan, Steven Z Pantilat, Stefan J Friedrichsdorf, Jori F Bogetz

{"title":"Inpatient Symptom Prevalence, Severity, and Improvement in Children Referred for Pediatric Palliative Care Consultation: Findings from a Multisite Quality Improvement Registry.","authors":"Andrea C Postier, Maggie C Root, David L O'Riordan, Steven Z Pantilat, Stefan J Friedrichsdorf, Jori F Bogetz","doi":"10.1016/j.jpeds.2025.114828","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114828","url":null,"abstract":"<p><strong>Objective: </strong>To describe the prevalence, severity, and changes in symptom distress in children with serious illness seen by inpatient pediatric palliative care (PPC).</p><p><strong>Study design: </strong>Cross-sectional retrospective analysis of a multisite, inpatient PPC quality improvement (QI) dataset. We examined symptom prevalence and severity at the first PPC visit for 9 symptoms in children. For the 5 most prevalent symptoms, distress scores were dichotomized (none to mild and moderate to severe) and were analyzed for associations with patient and clinical characteristics and for changes in distress scores from first to second PPC visit and first to last PPC visit prior to hospital discharge or death.</p><p><strong>Results: </strong>There were 1,769 patient encounters between 2016-2022 across five hospitals in the dataset. Children were a median age of 5 years old (IQR 1-11). The most common diagnostic group was solid tumor and hematological conditions (n=716, 40.9%). Moderate to severe fatigue (n=433, 51%), feeding issues (n=512, 50%), dyspnea (n=475, 41%), pain (n=442, 37%), and anxiety (n=308, 34%) were the 5 most prevalent symptoms. Moderate to severe symptom severity improved for all 5 symptoms (P<0.001) but feeding issues persisted for nearly one-quarter of children. Notably, moderate to severe fatigue, feeding issues, and dyspnea at initial PPC assessment were associated with a higher likelihood of in-hospital death (each P<0.05).</p><p><strong>Conclusions: </strong>In this dataset, moderate to severe symptoms often improved over the course of inpatient encounters. Moderate to severe fatigue, feeding issues, and dyspnea were associated with in-hospital death, suggesting a need to screen routinely for these symptoms as potential targets for improved PPC support.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114828"},"PeriodicalIF":3.5,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152050","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}

引用次数: 0

Increase in Health Care Utilization of Texas Infants with Congenital Anomalies Following Senate Bill 8 根据参议院第8号法案，德克萨斯州先天性畸形婴儿的医疗保健利用率增加。

IF 3.5 2区医学

Journal of Pediatrics Pub Date : 2025-09-18 DOI: 10.1016/j.jpeds.2025.114823

Sarah E. Peiffer MD , Mary Elizabeth Guerra MD , Kathleen E. Hosek MA , Shannon M. Larabee MD , Lily S. Cheng MD , Sundeep G. Keswani MD , Timothy C. Lee MD , Alice King MD

{"title":"Increase in Health Care Utilization of Texas Infants with Congenital Anomalies Following Senate Bill 8","authors":"Sarah E. Peiffer MD , Mary Elizabeth Guerra MD , Kathleen E. Hosek MA , Shannon M. Larabee MD , Lily S. Cheng MD , Sundeep G. Keswani MD , Timothy C. Lee MD , Alice King MD","doi":"10.1016/j.jpeds.2025.114823","DOIUrl":"10.1016/j.jpeds.2025.114823","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the impact of Texas Senate Bill 8 (SB8), which bans early abortion, on health care utilization of infants with congenital anomalies.</div></div><div><h3>Study design</h3><div>The Texas Inpatient Public Use Data File was queried for inpatient encounters of Texas patients <1 year old between July 1, 2020, and June 30, 2023. Encounters were grouped as pre-SB8 (July 1, 2020-June 30, 2021) and post-SB8 (July 1, 2022-June 30, 2023). Descriptive statistics and bivariate analyses were used to compare rates of congenital anomaly admissions, mortality, length of stay, and hospital charges.</div></div><div><h3>Results</h3><div>Among 1 149 242 infant inpatient admissions, 204 580 were for patients with congenital anomalies. Post-SB8, the proportions of anomaly admissions increased from 17.1% to 19.0% (<em>P</em> < .0001). Mortality and length of stay of these admissions remained similar. However, total charges for congenital anomaly admissions increased by $1.89 billion to over $8.7 billion post-SB8 (<em>P</em> < .0001), accounting for 56.5% of all inpatient charges despite comprising a minority of admissions.</div></div><div><h3>Conclusions</h3><div>Following SB8, inpatient admissions and charges for infants with congenital anomalies increased significantly. Although these patients represent a small proportion of admissions, their care accounts for a disproportionate share of hospital costs and increased by $1.89 billion following SB8. Future studies should explore outpatient costs and long-term outcomes following abortion restrictions.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"288 ","pages":"Article 114823"},"PeriodicalIF":3.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103228","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}

引用次数: 0

Racial, Ethnic, and Socioeconomic Disparities in Childhood Asthma Recovery in the United States. 美国儿童哮喘康复的种族、民族和社会经济差异。

IF 3.5 2区医学

Journal of Pediatrics Pub Date : 2025-09-17 DOI: 10.1016/j.jpeds.2025.114824

Elvin Khanjahani, Young-Rock Hong, Juha Baek, Frank D'Amico

{"title":"Racial, Ethnic, and Socioeconomic Disparities in Childhood Asthma Recovery in the United States.","authors":"Elvin Khanjahani, Young-Rock Hong, Juha Baek, Frank D'Amico","doi":"10.1016/j.jpeds.2025.114824","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114824","url":null,"abstract":"<p><strong>Objective: </strong>To examine racial, ethnic, and socioeconomic disparities in asthma prevalence and recovery among US children, using nationally representative data.</p><p><strong>Study design: </strong>We conducted a cross-sectional analysis of pooled data from the 2016-2022 National Survey of Children's Health. Multivariable logistic regression was used to estimate adjusted odds ratios (aORs) for current asthma and recovery. Complex sampling weights were applied for national estimates.</p><p><strong>Results: </strong>The sample included 277,215 children aged 0-17 years. Nationally 7.4% had a current asthma diagnosis, and 34.7% of those with a lifetime asthma diagnosis were classified as recovered. Non-Hispanic Black children had significantly higher odds of current asthma (aOR 2.03; 95% CI, 1.83-2.25) and lower odds of recovery (aOR 0.66; 95% CI, 0.56-0.79) compared with non-Hispanic White children. Hispanic children had moderately higher asthma prevalence (aOR 1.39; 95% CI, 1.24-1.55) but recovery odds that were statistically comparable with non-Hispanic White children (aOR 1.03; 95% CI, 0.87-1.22). Children from immigrant families had lower asthma prevalence (aOR 0.64; 95% CI, 0.57-0.72) and higher odds of recovery (aOR 1.50; 95% CI, 1.26-1.78). Socioeconomic disparities were also prominent: children living below the federal poverty level and those experiencing financial hardship were more likely to have current asthma and less likely to recover than their higher-income peers.</p><p><strong>Conclusions: </strong>Significant disparities in pediatric asthma extend beyond diagnosis to recovery, disproportionately affecting Black, low-income, and socioeconomically disadvantaged children. These findings underscore the need for equity-focused strategies to support long-term asthma management and recovery in pediatric populations.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114824"},"PeriodicalIF":3.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092928","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}

引用次数: 0

Body Roundness Index is a Stronger Predictor of Cardiometabolic Risk than Body Mass Index in Children between Ages 8 to 17 years 在8-17岁儿童中，身体圆度指数比身体质量指数更能预测心脏代谢风险。

IF 3.5 2区医学

Journal of Pediatrics Pub Date : 2025-09-17 DOI: 10.1016/j.jpeds.2025.114826

Afsana Jahan MD , Mahie M. Abdullah BSc , Rachel Frank BS, RN , Laura J. Castellanos MD , Pamela Singer MD, M , Carol L. Shen MD , Abby M. Basalely MD, MS , Christine B. Sethna MD, EdM

{"title":"Body Roundness Index is a Stronger Predictor of Cardiometabolic Risk than Body Mass Index in Children between Ages 8 to 17 years","authors":"Afsana Jahan MD , Mahie M. Abdullah BSc , Rachel Frank BS, RN , Laura J. Castellanos MD , Pamela Singer MD, M , Carol L. Shen MD , Abby M. Basalely MD, MS , Christine B. Sethna MD, EdM","doi":"10.1016/j.jpeds.2025.114826","DOIUrl":"10.1016/j.jpeds.2025.114826","url":null,"abstract":"<div><h3>Objective</h3><div>To determine whether body roundness index (BRI) is a stronger predictor of cardiometabolic outcomes compared with body mass index (BMI) in children.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 3996 children aged 8-17 from the 2015-2020 National Health and Nutrition Examination Survey database. Exposures were BMI and BRI z-scores. Primary outcomes were hypertensive blood pressure (BP) and BP index; secondary outcomes were serum glucose, insulin, and triglyceride levels. Complex regression models were adjusted for age, sex, poverty index ratio, food insecurity, and energy expenditure.</div></div><div><h3>Results</h3><div>BRI and BMI z-scores were individually associated with systolic and diastolic blood pressure indices. The addition of BRI to the BMI model strengthened the association with diastolic BP index, but not for systolic BP index. Although BMI z-scores were not associated with hypertensive BP, BRI z-scores were significantly associated with hypertensive BP (OR 1.497, 95% CI [1.175-1.907], <em>P</em> < .01). Adding BRI to BMI models improved the predictive fit for hypertensive BP as well as serum glucose, insulin, and triglyceride levels.</div></div><div><h3>Conclusions</h3><div>BRI is a stronger predictor of cardiometabolic outcomes compared with BMI, providing incremental value in cardiovascular risk assessment in children. Future studies should validate these findings and explore the clinical utility of BRI in pediatric settings.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"288 ","pages":"Article 114826"},"PeriodicalIF":3.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092898","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}

引用次数: 0

Emesis-Induced Facial Purpura 呕吐引起的面部紫癜。

IF 3.5 2区医学

Journal of Pediatrics Pub Date : 2025-09-17 DOI: 10.1016/j.jpeds.2025.114827

Wael Zaina MD, Mira Hamed MD, Michael Ziv MD

引用次数: 0

Timing of Critical Congenital Heart Defect Detection:A Multi-Site Population-Based Study. 关键先天性心脏缺陷检测的时机：一项基于多地点人群的研究。

IF 3.5 2区医学

Journal of Pediatrics Pub Date : 2025-09-17 DOI: 10.1016/j.jpeds.2025.114825

Shannon E Moss, Elizabeth Ailes, Karrie F Downing, Michael P Fundoraa, Elijah H Bolin, Suzan L Carmichael, Jill Glidewell, Rebecca F Liberman, Matthew E Ostera, Gary M Shaw, Sherry L Farr

{"title":"Timing of Critical Congenital Heart Defect Detection:A Multi-Site Population-Based Study.","authors":"Shannon E Moss, Elizabeth Ailes, Karrie F Downing, Michael P Fundoraa, Elijah H Bolin, Suzan L Carmichael, Jill Glidewell, Rebecca F Liberman, Matthew E Ostera, Gary M Shaw, Sherry L Farr","doi":"10.1016/j.jpeds.2025.114825","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114825","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate prevalence of and characteristics associated with prenatal and late critical congenital heart defect (CCHD) detection among infants.</p><p><strong>Study design: </strong>Infants with CCHD born during 2014-2021 with interviewed mothers were included from the Birth Defects Study To Evaluate Pregnancy exposureS (BD-STEPS), a multi-site, population-based case-control study. Timing of detection was based on date of earliest fetal or postnatal echocardiogram: prenatal, timely postnatal (0-3 days after birth), and late (>3 days after birth). Unadjusted log-linear models evaluated trends in timing of CCHD detection by birth year. Multivariable log-binomial models calculated adjusted prevalence ratios (aPRs) for prenatal and late CCHD detection by demographic and clinical characteristics.</p><p><strong>Results: </strong>There were 996 liveborn infants with CCHD included in this analysis. Prenatal detection increased from 2014 (25.0%) to 2021 (39.1%; P for trend=0.01). The prevalence of late detection was 22.7% in 2014 and 16.4% in 2021; P=0.06. Almost half (48.6%) of infants had timely postnatal detection. Prenatal detection was 1.2 times (95% CI 1.1-1.5) more likely among infants with extracardiac compared with isolated defects. Late CCHD detection was 2.0 times (95% CI 1.2-3.4) more common among infants whose mothers lacked prenatal insurance compared with those with prenatal insurance.</p><p><strong>Conclusions: </strong>Disparities in timing of CCHD detection exist by defect characteristics and insurance. Implementation of improved prenatal detection methods to detect more defect types and interventions to increase access to prenatal care may further improve earlier CCHD detection.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114825"},"PeriodicalIF":3.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092972","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}

引用次数: 0

Accelerating Guideline-Recommended Universal Pediatric Lipid Screening: Launch of the LEAD Pediatric Initiative 加速指南推荐的普遍儿科脂质筛查：启动LEAD儿科倡议。

IF 3.5 2区医学

Journal of Pediatrics Pub Date : 2025-09-17 DOI: 10.1016/j.jpeds.2025.114804

Jonathan N. Flyer MD , Sadia Malik MD, MPH , Jacob Hartz MD, MPH , Jennifer L. Farnell MA , Courtney E. Riley MD , Robert Wiskind MD , Carissa Baker-Smith MD, MPH , Sarah D. de Ferranti MD, MPH , Corinna Rea MD, MPH , Adam L. Ware MD , Laurence Sperling MD , Stephen R. Daniels MD, MPH, PhD

引用次数: 0

Conical Incisors as the First Manifestation of Hypohidrotic Ectodermal Dysplasia 锥形门牙是少汗性外胚层发育不良的首要表现。

IF 3.5 2区医学

Journal of Pediatrics Pub Date : 2025-09-17 DOI: 10.1016/j.jpeds.2025.114822

Eiki Ogawa MD, Kenta Ito MD

引用次数: 0

Rising Food and Diet Adverse Events in United States Children: A Call for Better Food Labeling and Nutrition Documentation 美国儿童食品和饮食不良事件的增加：呼吁更好的食品标签和营养文件。

IF 3.5 2区医学

Journal of Pediatrics Pub Date : 2025-09-16 DOI: 10.1016/j.jpeds.2025.114821

Jeannie S. Huang MD, MPH , Jocelyn Young MD , Mary Abigail Garcia MD

引用次数: 0