Journal of Pediatrics最新文献

{"title":"The Association of Opioid Prescriptions to Children after Discharge from Surgery and New Opioid Prescription Fills in Family Members.","authors":"Erica Langnas, Andrew Lin, Yanting Luo, Rosa Rodriguez-Monguio, Mark Bicket, Sara Cairo, Mathijs De Vaan, Catherine L Chen","doi":"10.1016/j.jpeds.2025.114505","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114505","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether family members of pediatric surgical patients who filled a discharge opioid prescription would have higher rates of new opioid prescription fills compared with family members of patients who did not fill a pediatric surgical discharge opioid prescription.</p><p><strong>Study design: </strong>Using OptumLabs Data Warehouse administrative claims, we performed a retrospective cohort study of pediatric surgery patients aged 5 through18 and their family members, based on whether an opioid prescription for the child was filled after surgery. Neither patients nor family members had any history of prior opioid use. We calculated the frequency of new opioids filled among family members in the 12 months following the date of surgery. We created a hierarchical logistic regression model to determine the association between having a discharge opioid prescription filled for a pediatric surgical patient and a new opioid prescription filled by family members within the same household.</p><p><strong>Results: </strong>There were a total of 206,598 family members within 76,569 households in our study. 73.75% of pediatric surgery patients had a prescription filled after surgery, resulting in 151,693 total family members within 56,456 households exposed to a new discharge opioid prescription. 7.3% of exposed family members and 19.6% exposed households then filled a new opioid prescription within 12 months, compared with 5.2% of family members and 13.3% of households (p<0.001 for both) unexposed to a filled opioid prescription after pediatric surgical discharge . After adjusting for demographic factors, clinical attributes, and surgical factors, we found an increased risk of new opioid prescription fills among exposed family members compared with unexposed family members (OR 1.28 [95% CI 1.217, 1.352, p<0.001]).</p><p><strong>Conclusions: </strong>Introducing a discharge opioid prescription after pediatric surgery to an opioid-naïve household is associated with increased rates of opioid prescriptions in opioid-naïve family members in the year following surgery.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114505"},"PeriodicalIF":3.9,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374984","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":"Quantitative Magnetic Resonance Cerebrospinal Fluid Flow Properties and Neurocognitive Outcomes in Congenital Heart Disease","authors":"Vincent Kyu Lee BS ,&nbsp;William T. Reynolds BS ,&nbsp;Rebecca R. Hartog MD ,&nbsp;Julia Wallace BA ,&nbsp;Nancy Beluk RT ,&nbsp;Jodie K. Votava-Smith MD ,&nbsp;Daryaneh Badaly PhD ,&nbsp;Cecilia W. Lo PhD ,&nbsp;Rafael Ceschin PhD ,&nbsp;Ashok Panigrahy MD","doi":"10.1016/j.jpeds.2025.114494","DOIUrl":"10.1016/j.jpeds.2025.114494","url":null,"abstract":"<div><h3>Objectives</h3><div>To determine whether there are differences in pulsatile cerebrospinal fluid (CSF) flow between children and adolescents with congenital heart disease (CHD) and healthy, age-matched peers, and to determine if abnormal CSF flow is associated with abnormal CSF volumes and whether it predicts executive function outcomes.</div></div><div><h3>Study design</h3><div>CSF flow was measured across the lumen of the aqueduct of Sylvius using cardiac-gated phase-contrast MRI at 3.0 T on 60 children and adolescents (CHD = 22, healthy controls = 38). CSF flow modeled as standard pulsatility characteristics (anterograde and retrograde peak velocities, mean velocity, and velocity variance measurements) and dynamic pulsatility characteristics (each participant's CSF flow deviation from study cohort's consensus flow quantified using the root mean squared deviation) were measured. Participants underwent neurocognitive assessments for executive function, focused on inhibition, cognitive flexibility, and working memory domains.</div></div><div><h3>Results</h3><div>Compared with controls, the CHD group demonstrated greater dynamic pulsatility over the entire cardiac cycle (higher overall flow root mean squared deviation: <em>P</em> = .0353 for the study cohort fitted; <em>P</em> = .0292 for the control only fitted), but no difference in standard pulsatility measures. However, a lower mean velocity (<em>P</em> = .0323) and lower dynamic CSF flow pulsatility (root mean squared deviation <em>P</em> = .0181 for the study cohort fitted; <em>P</em> = .0149 for the control only fitted) predicted poor inhibitory executive functional outcomes.</div></div><div><h3>Discussion</h3><div>Although the whole CHD group exhibited higher dynamic CSF flow pulsatility compared with controls, the subset of patients with CHD with relatively reduced static and dynamic CSF flow pulsatility had the worst inhibitory domain executive functioning. These findings suggest that altered CSF flow pulsatility may be related to not only brain compensatory mechanisms, but also to cognitive impairment in CHD.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"280 ","pages":"Article 114494"},"PeriodicalIF":3.9,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconsidering Initial Respiratory Support Strategies in Infants Born Preterm","authors":"Yinfang Wu MM,&nbsp;Weixing Xu MM","doi":"10.1016/j.jpeds.2024.114394","DOIUrl":"10.1016/j.jpeds.2024.114394","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114394"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632631","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 Association of the Child Opportunity Index with Emergency Department Presentations for Pediatric Poisonings: A Case-Control Study","authors":"Michael S. Toce MD, MS ,&nbsp;Claire Narang BS ,&nbsp;Michael C. Monuteaux ScD ,&nbsp;Florence T. Bourgeois MD, MPH","doi":"10.1016/j.jpeds.2024.114410","DOIUrl":"10.1016/j.jpeds.2024.114410","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the relationship between the Child Opportunity Index (COI) and unintentional poisonings in a geographically diverse pediatric population.</div></div><div><h3>Study design</h3><div>We conducted a retrospective, case-control study of children ≤ 6 years of age who had emergency department encounters for poisonings from January 1, 2016, to December 31, 2021. Data were obtained from the Pediatric Health Information System database. Poisonings were categorized as related to prescription medications, over-the-counter medications, drugs of misuse, or nonmedicinal substances. We estimated multivariable conditional logistic regression models to examine the association of the COI with each poisoning type.</div></div><div><h3>Results</h3><div>Among 49 789 emergency department encounters for poisonings, the most common poisoning category was prescription medications (28.3%). Compared with patients with very low COI, patients with very high COI were more likely to present for prescription medication (aOR 1.15 [95% CI, 1.01-1.31]) or over-the-counter medication poisoning (aOR 1.37 [95% CI, 1.18-1.59]). Conversely, patients with very high COI were less likely to have poisonings secondary to drugs of misuse (aOR 0.82 [95% CI, 0.67-0.99]). Patients with high COI were also less likely to have poisonings due to a nonmedicinal substance compared with patients with very low COI (aOR 0.83 [95% CI, 0.73-0.93]).</div></div><div><h3>Conclusions</h3><div>Different pediatric poisoning types were associated with a patient's COI, possibly reflecting socioeconomic characteristics of a child's environment. While poison prevention strategies should be employed uniformly to maximize impact, our findings highlight variation in poisoning risks related to a child's environment and support the use of the COI for future research into mechanisms to strengthen further poisoning prevention strategies.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114410"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649478","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":"Why the Negative? A Reflective Analysis on the Impact of Weekly Vitamin D Supplementation on Acute Respiratory Infections in Young Children","authors":"Yahong Wang MSc,&nbsp;Yupeng Ruan MBBS","doi":"10.1016/j.jpeds.2024.114417","DOIUrl":"10.1016/j.jpeds.2024.114417","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114417"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695789","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":"Corrigendum to “Cognitive Bias in an Infant with Constipation” J Pediatrics 270 (2024): 113996","authors":"Rebecca A. Carson DNP, APRN, CPNP, PC/AC ,&nbsp;John L. Lyles MD","doi":"10.1016/j.jpeds.2024.114406","DOIUrl":"10.1016/j.jpeds.2024.114406","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114406"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820335","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":"Advancing Very Early Intervention for Infants with Cerebral Palsy","authors":"Alicia J. Spittle PhD","doi":"10.1016/j.jpeds.2025.114466","DOIUrl":"10.1016/j.jpeds.2025.114466","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114466"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143147601","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":"Congenital Goiter due to Inborn Error in Synthesis with Treatment Response","authors":"Ankush Patel BS,&nbsp;Rekha Krishnasarma MD","doi":"10.1016/j.jpeds.2024.114387","DOIUrl":"10.1016/j.jpeds.2024.114387","url":null,"abstract":"","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114387"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Pittsburgh Study: A Tiered Model to Support Parents during Early Childhood","authors":"Chelsea Weaver Krug PhD ,&nbsp;Alan L. Mendelsohn MD ,&nbsp;Jordan Wuerth MS ,&nbsp;Erin Roby PhD ,&nbsp;Daniel S. Shaw PhD","doi":"10.1016/j.jpeds.2024.114396","DOIUrl":"10.1016/j.jpeds.2024.114396","url":null,"abstract":"<div><h3>Objective</h3><div>To test the feasibility of implementing The Pittsburgh Study's (TPS) Early Childhood Collaborative, a population-level, community-partnered initiative to promote relational health by offering accessible preventive parenting program options for families with young children.</div></div><div><h3>Study design</h3><div>TPS partnered with healthcare and community agencies serving families in Allegheny County, Pennsylvania, to enroll and screen 878 parents of 1040 children 4-years-old and under. Participants were assigned to 1 of 4 tiered groups based on identified needs: (1) universal, (2) targeted/universal, (3) secondary/tertiary, or (4) tertiary programs. Parents were offered choices in empirically supported parenting programs within group ranging from texting programs to intensive home visiting. Program selection was optional. Chi-square tests were conducted to examine the likelihood of selecting a program by group.</div></div><div><h3>Results</h3><div>About 25% of participants were assigned to each tiered group; 78% of parents chose to enroll in a parenting program. In general, parents with higher levels of adversity were more likely to select a parenting program compared with those reporting less adversity, including secondary/tertiary vs targeted/universal groups (81.4% vs 72.8%), and tertiary vs universal and targeted/universal groups (83% vs 74.1% and 72.8%, respectively; <em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Our high program enrollment rate supports the feasibility of TPS. TPS successfully engaged families in the study by offering choices in, and optimizing accessibility to, parenting programs. TPS is highly aligned with recent recommendations by the American Academy of Pediatrics for tiered approaches as part of a broad public health strategy for supporting early relational health.</div></div><div><h3>Trial Registration</h3><div>The Pittsburgh Study Early Childhood (TPS-ECC): NCT05444205.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114396"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Markers of Environmental Enteric Dysfunction are Associated with Poor Growth and Developmental Outcomes among Young Children in Lusaka, Zambia","authors":"Jacqueline M. Lauer PhD, MPH ,&nbsp;Juha Pyykkö PhD ,&nbsp;Mpela Chembe BA ,&nbsp;Tamara Billima-Mulenga MA ,&nbsp;Dorothy Sikazwe MPH ,&nbsp;Bertha Chibwe MPH ,&nbsp;Savanna Henderson MA ,&nbsp;Doug Parkerson MA ,&nbsp;Jukka M. Leppänen PhD ,&nbsp;Günther Fink PhD ,&nbsp;Lindsey M. Locks ScD, MPH ,&nbsp;Peter C. Rockers ScD","doi":"10.1016/j.jpeds.2024.114408","DOIUrl":"10.1016/j.jpeds.2024.114408","url":null,"abstract":"<div><h3>Objective</h3><div>To examine cross-sectional relationships between biomarkers of environmental enteric dysfunction (EED), an acquired subclinical condition of the small intestine, and anthropometric and developmental outcomes among children in Lusaka, Zambia.</div></div><div><h3>Study design</h3><div>Serum samples were collected from 240 children aged 27 to 35 months enrolled in a cluster-randomized trial assessing the effects of growth charts and small-quantity lipid-based nutrient supplements on linear growth. Samples were analyzed using the 11-plex Micronutrient and EED Assessment Tool, which incorporates 2 biomarkers of EED, namely intestinal fatty acid-binding protein (I-FABP), a marker of epithelial damage, and soluble CD14 (sCD14), a marker of microbial translocation. Associations between log₂-transformed biomarker concentrations and anthropometric (height-for-age z-score [HAZ], weight-for-height z-score, and weight-for-age z-score) and developmental (Global Scales of Early Development development for age z-score and saccadic reaction time [SRT]) outcomes were assessed using linear regression analyses adjusted for background characteristics.</div></div><div><h3>Results</h3><div>Mean ± SD HAZ was −1.94 ± 1.10. Higher sCD14 and I-FABP concentrations were significantly associated with lower HAZ (β: −0.21, 95% CI: −0.41, −0.01 and β: −0.20, 95% CI: −0.32, −0.08, respectively). Higher I-FABP concentrations were significantly associated with lower development-for-age z-score (β: −0.22, 95% CI: −0.40, −0.03) and slower SRT (β: 7.37 ms, 95% CI: 2.02, 12.72) as were higher alpha-1-acid glycoprotein concentrations (HAZ β: −0.38, 95% CI: −0.72, −0.03; SRT β: 11.14 ms, 95% CI: 0.94, 21.72).</div></div><div><h3>Conclusions</h3><div>In children in Lusaka, biomarkers of EED were associated with poor anthropometric and developmental outcomes, underscoring the need for interventions to address EED to improve child health globally.</div></div><div><h3>Clinical Trial Registry</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> identifier for parent trial: <span><span>NCT05120427</span><svg><path></path></svg></span>. <span><span>https://clinicaltrials.gov/ct2/show/NCT05120427</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"277 ","pages":"Article 114408"},"PeriodicalIF":3.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649549","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}