Journal of Pediatrics最新文献_第3页

Association Between Platelet Count and Bleeding During Central Line Placement in Critically Ill Children.

IF 3.9 2区医学

Journal of Pediatrics Pub Date : 2025-03-14 DOI: 10.1016/j.jpeds.2025.114539

Alexandra T Lucas, Walter Dzik

{"title":"Association Between Platelet Count and Bleeding During Central Line Placement in Critically Ill Children.","authors":"Alexandra T Lucas, Walter Dzik","doi":"10.1016/j.jpeds.2025.114539","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114539","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between platelet count and procedure-related bleeding at the time of central venous line (CVL) placement in critically ill children.</p><p><strong>Study design: </strong>A retrospective cohort study was performed capturing patient admissions to the pediatric intensive care unit between January 1, 2012 to March 1, 2022. Critically ill children between 0 months and 19 years who underwent bedside CVL placement were included. A total of 363 were included in the final analysis.</p><p><strong>Results: </strong>Patients' platelet counts prior to line placement ranged from 11,000/uL to 735,000/uL. Bleeding was identified in 26 of 363 (7.2%) of patients, and was categorized as 24 (92%) minimal, 2 (8%) moderate, and none severe. Platelet count and platelet transfusion before line placement were both significantly different between bleeding and non-bleeding patients (p = 0.04 and p = 0.032). Patients with lower platelet counts had a higher proportion of bleeding events. There were no significant differences between the bleeding and non-bleeding groups in age, sex, history of bleeding, or number of attempts at CVL. Patients with bleeding were not significantly sicker. Regression analysis determined that female sex and transfusion before CVL placement were both significantly associated with bleeding.</p><p><strong>Conclusions: </strong>We found that the platelet count prior to CVL placement was not associated with bleeding events in critically ill pediatric patients. Bleeding was more common in patients receiving platelet transfusions. Additional studies are needed to evaluate further the effect of platelet transfusions on procedure-related bleeding.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114539"},"PeriodicalIF":3.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639856","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

Association of Enteral Feed Type with Neurodevelopmental and Neonatal Outcomes among Infants Born Preterm. 早产儿肠内喂养类型与神经发育和新生儿结局的关系

IF 3.9 2区医学

Journal of Pediatrics Pub Date : 2025-03-13 DOI: 10.1016/j.jpeds.2025.114536

Nicole Bando, Eugene W Yoon, Marc Beltempo, Cecilia de Cabo, Lindsay Colby, Wissam Alburaki, Thevanisha Pillay, Prakesh S Shah

{"title":"Association of Enteral Feed Type with Neurodevelopmental and Neonatal Outcomes among Infants Born Preterm.","authors":"Nicole Bando, Eugene W Yoon, Marc Beltempo, Cecilia de Cabo, Lindsay Colby, Wissam Alburaki, Thevanisha Pillay, Prakesh S Shah","doi":"10.1016/j.jpeds.2025.114536","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114536","url":null,"abstract":"<p><strong>Objective: </strong>To examine associations between enteral feed type with neurodevelopmental and neonatal outcomes among infants born preterm.</p><p><strong>Study design: </strong>This was a retrospective study of enteral feeds in the first 28 postnatal days in infants born <29 weeks' gestation from 2015 through 2020 in neonatal units of the Canadian Neonatal Network and Canadian Neonatal Follow-Up Network. Feeds were examined as a compositional variable comprised of the proportion of days fed mother's milk, donor milk, mixed feeds, and nil per os (NPO), the proportions of which sum to 1. Associations between enteral feed type with neurodevelopmental outcomes at 18 to 24 months corrected age and neonatal morbidities were examined.</p><p><strong>Results: </strong>Our cohort included 2104 infants with a mean (SD) gestational age of 26.2 (1.5) weeks (52.9% male). Compositional data analysis revealed a one-day reallocation from mother's milk to donor milk was associated with greater odds of cognitive (aOR: 1.028, 95%CI: 1.001, 1.056) and language impairment (aOR: 1.024, 95%CI: 1.002, 1.047). Replacing one day of mixed feeds, donor milk or NPO with mother's milk was associated with improved cognitive, language and motor development. A one-day reallocation of NPO to either mother's milk, mixed feeds or donor milk decreased odds of significant neurodevelopmental impairment, cerebral palsy and/or necrotizing enterocolitis.</p><p><strong>Conclusions: </strong>Donor milk in place of mother's milk was associated with poorer cognitive and language development. Providing any human milk reduced neurodevelopmental impairment and necrotizing enterocolitis with reallocations involving mother's milk yielding the most benefit. Promoting early enteral nutrition with mother's milk should be a priority in the care of infants born preterm.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114536"},"PeriodicalIF":3.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143635000","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

Urine Testing in Children with Viral Symptoms: A Nationwide Analysis of Ambulatory Visits, 2014-2019

IF 3.9 2区医学

Journal of Pediatrics Pub Date : 2025-03-12 DOI: 10.1016/j.jpeds.2025.114538

Rachel L. Wattier MD, MHS , Daniel J. Shapiro MD, MPH , Hillary L. Copp MD, MS , Sunitha V. Kaiser MD, MSc , Adam L. Hersh MD, PhD

{"title":"Urine Testing in Children with Viral Symptoms: A Nationwide Analysis of Ambulatory Visits, 2014-2019","authors":"Rachel L. Wattier MD, MHS , Daniel J. Shapiro MD, MPH , Hillary L. Copp MD, MS , Sunitha V. Kaiser MD, MSc , Adam L. Hersh MD, PhD","doi":"10.1016/j.jpeds.2025.114538","DOIUrl":"10.1016/j.jpeds.2025.114538","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the extent of and factors associated with urine testing in US pediatric ambulatory visits for symptoms commonly associated with viral illness.</div></div><div><h3>Study design</h3><div>We analyzed a nationally representative, cross-sectional sample of ambulatory clinic and emergency department (ED) visits among children 2 months to 17 years old (2014 through 2019 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey). Using reason for visit classification codes, we identified visits for respiratory symptoms, diarrhea, or rash; termed “viral symptoms” without reported localizing genitourinary symptoms. We assessed the proportion of these visits with urine testing (urinalysis and/or urine culture) and evaluated factors associated with urine testing using logistic regression.</div></div><div><h3>Results</h3><div>Of 71.3 million (95% CI 64.7-78.0 million) pediatric ambulatory visits per year, 61% (95% CI 59%-63%) were for viral symptoms without reported genitourinary symptoms. Urine testing at these visits accounted for 38% (95% CI 30%-47%) of overall urine testing. Such testing occurred more frequently at ED visits (8.3%; 95% CI 7.4%-9.3%) compared with clinic visits (4.4%; 95% CI 2.5%-7.7%). At ED visits, the adjusted probability of urine testing in the context of viral symptoms was lowest for males age 2 months to <2 years (5%; 95% CI 3%-6%) and highest for females age 12 through 17 years (20%; 95% CI 16%-24%), and females age 6-11 years (13%; 95% CI 11%-16%).</div></div><div><h3>Conclusions</h3><div>Urine testing in children with symptoms of viral or other non-urinary tract infection illnesses occurs frequently at ambulatory visits. This potentially avoidable testing disproportionately occurred in older age groups that have lower risk of urinary tract infection.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"281 ","pages":"Article 114538"},"PeriodicalIF":3.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630983","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}

引用次数: 0

Health Disparities in Diagnosis and Treatment of Heterozygous Familial Hypercholesterolemia.

IF 3.9 2区医学

Journal of Pediatrics Pub Date : 2025-03-12 DOI: 10.1016/j.jpeds.2025.114537

Rachel J Shustak, Abigail Perlstein, Amanda S Artis, Alexis Z Tomlinson, Vicky Tam, Giordana Martino, Julie A Brothers

{"title":"Health Disparities in Diagnosis and Treatment of Heterozygous Familial Hypercholesterolemia.","authors":"Rachel J Shustak, Abigail Perlstein, Amanda S Artis, Alexis Z Tomlinson, Vicky Tam, Giordana Martino, Julie A Brothers","doi":"10.1016/j.jpeds.2025.114537","DOIUrl":"https://doi.org/10.1016/j.jpeds.2025.114537","url":null,"abstract":"<p><strong>Objective: </strong>To examine the association of social determinants of health and age at heterozygous familial hypercholesterolemia (HeFH) diagnosis and treatment.</p><p><strong>Study design: </strong>We performed a retrospective, single-center study of children with HeFH. Multivariable linear regression models were used to examine the association between Child Opportunity Index (COI) and age at HeFH diagnosis and statin initiation. Additional covariates included sex, race, ethnicity, health insurance type, primary language, body mass index (BMI) percentile, and LDL-C. To explore potential referral bias, we compared the COI of the study cohort with that of the institution's catchment area.</p><p><strong>Results: </strong>We evaluated 577 patients. The median age at presentation was 12 (9, 14) years and the median LDL-C was 199 (169, 235) mg/dL; 58% were prescribed a statin at a median age of 13 (10, 15) years. There was no association between COI and the age at HeFH diagnosis or statin initiation. On multivariable analysis, Black race was associated with older age at HeFH diagnosis but not statin initiation compared with White race (adjusted estimate 1.1 +/- 0.50 yrs, p = 0.023). Higher LDL-C, male sex, and lower BMI percentile were associated with younger age at HeFH diagnosis and statin initiation. The COI of the study cohort was significantly higher than that of the catchment area (p < 0.001).</p><p><strong>Conclusions: </strong>Black race was associated with older age at HeFH diagnosis; however, there were no differences in age at statin initiation. The COI of the cohort was significantly higher than that of the catchment area indicating that low COI populations are likely under-referred for HeFH evaluation.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114537"},"PeriodicalIF":3.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631066","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

Neonatal Neurobehavior Predicts Neonatal Opioid Withdrawal Syndrome Severity Prior to Treatment Interventions 新生儿神经行为可预测治疗干预前新生儿阿片类药物戒断综合征的严重程度。

IF 3.9 2区医学

Journal of Pediatrics Pub Date : 2025-03-11 DOI: 10.1016/j.jpeds.2025.114533

Sarah E. Maylott PhD , Madeleine Bruce PhD , Lydia Brown BS , Ayla J. Castano BS , Lynne Dansereau MSPH , Barry Lester PhD , Elisabeth Conradt PhD

{"title":"Neonatal Neurobehavior Predicts Neonatal Opioid Withdrawal Syndrome Severity Prior to Treatment Interventions","authors":"Sarah E. Maylott PhD , Madeleine Bruce PhD , Lydia Brown BS , Ayla J. Castano BS , Lynne Dansereau MSPH , Barry Lester PhD , Elisabeth Conradt PhD","doi":"10.1016/j.jpeds.2025.114533","DOIUrl":"10.1016/j.jpeds.2025.114533","url":null,"abstract":"<div><h3>Objective</h3><div>To utilize the NeoNatal Neurobehavioral Scale (NNNS-II) as a standardized and reliable tool to help guide treatment of neonatal opioid withdrawal syndrome (NOWS) with the goal of improving the consistency and quality of care provided to opioid-exposed newborns.</div></div><div><h3>Study design</h3><div>We examined NOWS severity through several indicators, including the number of pharmacological treatment medications, maximum dose of medications, length of treatment, and maximum score on NOWS observational tools to create an overall severity score for each newborn. Then we examined whether NOWS risk could be detected as early as 24 hours after birth using the NNNS-II to predict NOWS severity.</div></div><div><h3>Results</h3><div>Newborn neurobehavior prior to signs of NOWS predicted NOWS severity. Newborns who were more hypertonic and had poorer quality of movement had higher severity scores.</div></div><div><h3>Conclusion</h3><div>These findings indicate that NOWS risk detection may be enhanced with an early newborn neurobehavioral assessment.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"281 ","pages":"Article 114533"},"PeriodicalIF":3.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626996","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

Information for Readers

IF 3.9 2区医学

Journal of Pediatrics Pub Date : 2025-03-10 DOI: 10.1016/S0022-3476(25)00059-9

引用次数: 0

Neurobehavioral Profiles in Opioid-Exposed and Unexposed Neonates

IF 3.9 2区医学

Journal of Pediatrics Pub Date : 2025-03-07 DOI: 10.1016/j.jpeds.2025.114527

Stephanie L. Merhar MD, MS , Kimberly Yolton PhD , Sara B. DeMauro MD, MSCE , Traci Beiersdorfer RN, BSN , Jamie E. Newman PhD , Scott A. Lorch MD, MSCE , Deanne Wilson-Costello MD , Namasivayam Ambalavanan MD , Ananta Bangdiwala MS , Myriam Peralta-Carcelen MD , Brenda B. Poindexter MD , Jonathan M. Davis MD , Catherine Limperopoulos PhD , Carla M. Bann PhD

{"title":"Neurobehavioral Profiles in Opioid-Exposed and Unexposed Neonates","authors":"Stephanie L. Merhar MD, MS , Kimberly Yolton PhD , Sara B. DeMauro MD, MSCE , Traci Beiersdorfer RN, BSN , Jamie E. Newman PhD , Scott A. Lorch MD, MSCE , Deanne Wilson-Costello MD , Namasivayam Ambalavanan MD , Ananta Bangdiwala MS , Myriam Peralta-Carcelen MD , Brenda B. Poindexter MD , Jonathan M. Davis MD , Catherine Limperopoulos PhD , Carla M. Bann PhD","doi":"10.1016/j.jpeds.2025.114527","DOIUrl":"10.1016/j.jpeds.2025.114527","url":null,"abstract":"<div><h3>Objective</h3><div>To describe distinctive profiles of neurobehavior in opioid-exposed and unexposed neonates.</div></div><div><h3>Study design</h3><div>The Outcomes of Babies with Opioid Exposure study is a multisite, prospective, observational study in neonates born at term with opioid exposure and unexposed controls. As part of the Outcomes of Babies with Opioid Exposure study protocol, certified examiners administered the NeoNatal Neurobehavioral Scales, second edition (NNNS-II) before 6 weeks postnatal age. We used latent profile analysis to determine distinctive classes of neurobehavior and linear mixed effect models to compare NNNS-II scores by exposure status.</div></div><div><h3>Results</h3><div>The study included 291 neonates with NNNS-II, 194 exposed and 97 unexposed. Latent profile analysis resulted in 4 unique classes. Class 4 showed the most signs of stress and included almost exclusively exposed neonates. Scores for exposed neonates were significantly different than unexposed neonates on most NNNS-II subscales. In addition to opioids, associations were found between profile membership and prenatal exposure to benzodiazepines, e-cigarettes/tobacco, and selective serotonin reuptake inhibitors.</div></div><div><h3>Conclusions</h3><div>Neonates with prenatal exposure to opioids and other psychotropic substances have distinctive patterns of neurobehavior. Additional follow-up is needed to determine if these neurobehavioral differences serve as a marker for future problems with attention and behavior.</div></div><div><h3>Clinical Trials.gov Registration</h3><div><span><span>NCT04149509</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"281 ","pages":"Article 114527"},"PeriodicalIF":3.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588258","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

The Interaction of Antenatal Steroid Timing and Pre-Eclampsia on Respiratory Outcomes Among Infants Born Preterm

IF 3.9 2区医学

Journal of Pediatrics Pub Date : 2025-03-07 DOI: 10.1016/j.jpeds.2025.114526

April W. Tan MD , Mohamed Hamza MD , Chanique James MD , Alini Schott RN, MS , Ana Cecilia Aguilar RRT , Eduardo Bancalari MD , Augusto F. Schmidt MD, PhD , Nelson Claure MSc, PhD

{"title":"The Interaction of Antenatal Steroid Timing and Pre-Eclampsia on Respiratory Outcomes Among Infants Born Preterm","authors":"April W. Tan MD , Mohamed Hamza MD , Chanique James MD , Alini Schott RN, MS , Ana Cecilia Aguilar RRT , Eduardo Bancalari MD , Augusto F. Schmidt MD, PhD , Nelson Claure MSc, PhD","doi":"10.1016/j.jpeds.2025.114526","DOIUrl":"10.1016/j.jpeds.2025.114526","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effect of timing of antenatal steroid (ANS) administration and its interaction with pre-eclampsia on respiratory outcome among infants born preterm.</div></div><div><h3>Study design</h3><div>This was an analysis of a prospective, single-center cohort of infants born between 23 and 30 weeks of gestation between 2012 through 2021. End points were severe respiratory distress syndrome (sRDS) and moderate-to-severe bronchopulmonary dysplasia (msBPD). ANS administration was classified as within 7 days of birth or earlier than 7 days before birth. Multivariable generalized estimating equations were used to model the association between ANS timing and pre-eclampsia with the end points.</div></div><div><h3>Results</h3><div>The cohort included 1172 infants, of whom 30% were born to mothers with pre-eclampsia and 83% to mothers who received ANS within 7 days of birth. Compared with non–pre-eclampsia with ANS within 7 days of birth, pre-eclampsia with ANS earlier than 7 days before birth was associated with an increased risk for sRDS. Pre-eclampsia with ANS within 7 days of birth was not associated with an increased risk for sRDS. Compared with non–pre-eclampsia with ANS within 7 days of birth, non–pre-eclampsia with ANS earlier than 7 days of birth, and pre-eclampsia with ANS earlier than 7 days before birth were associated with an increased risk for msBPD. Pre-eclampsia with ANS within 7 days of birth was not associated with increased risk of msBPD.</div></div><div><h3>Conclusions</h3><div>In this cohort, properly timed maternal ANS administration within 7 days of birth was associated with a reduced risk of sRDS and msBPD among infants born preterm to mothers with pre-eclampsia. These findings underscore the need to optimize the timing of ANS administration.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"281 ","pages":"Article 114526"},"PeriodicalIF":3.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588279","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

A Foundational Understanding of Rural-Urban Differences in the Pediatric Workforce for Children with Medical Complexity.

IF 3.9 2区医学

Journal of Pediatrics Pub Date : 2025-03-07 DOI: 10.1016/j.jpeds.2025.114531

Caitlin Koob, S Margaret Wright, Carolyn Foster

引用次数: 0

Management Variation in Pediatric Labial Adhesions: A Retrospective Cohort Study

IF 3.9 2区医学

Journal of Pediatrics Pub Date : 2025-03-06 DOI: 10.1016/j.jpeds.2025.114529

Riley J. O'Keefe BS, Sarah D. Compton PhD, MPH, Melina L. Dendrinos MD, Monica W. Rosen MD

{"title":"Management Variation in Pediatric Labial Adhesions: A Retrospective Cohort Study","authors":"Riley J. O'Keefe BS, Sarah D. Compton PhD, MPH, Melina L. Dendrinos MD, Monica W. Rosen MD","doi":"10.1016/j.jpeds.2025.114529","DOIUrl":"10.1016/j.jpeds.2025.114529","url":null,"abstract":"<div><h3>Objective</h3><div>To compare treatment and outcome differences between primary care providers (PCPs), pediatric and adolescent gynecologists (PAGs), and pediatric urologists (PURs) in management of labial adhesions (LAs).</div></div><div><h3>Study design</h3><div>This was a retrospective, cohort study of patients aged 0 through 21 presenting for a clinic visit from July 2022 to July 2023 at a single institution, identified by International Classification of Diseases 9th revision/10th revision codes for LA. Management variation was analyzed via cross-tabs with chi-square, Fisher exact test, and two-sample <em>t</em>-tests.</div></div><div><h3>Results</h3><div>The 159 patients meeting inclusion criteria had a median age of 12 months at diagnosis; 81 were managed by a PCP and 78 were referred to a specialist: 41 (52.6%) PUR, 32 (41.0%) PAG, and 5 (6.4%) other specialists. Forty-one patients presented with urinary issues, with no difference in rate of referral to PUR (37.8%), PAG (15.5%), or continued PCP management (46.7%), <em>P</em> = .17. All patients were initially treated nonsurgically. Surgical intervention rates did not differ between PAG and PUR (<em>P</em> = .21). PUR performed sharp adhesiolysis more often than PAG (<em>P</em> = .011), but there was no difference in blunt adhesiolysis rates between PAG and PUR (<em>P</em> = .17). LA recurred postoperatively in 6 (3.8%) patients.</div></div><div><h3>Conclusions</h3><div>These results reiterate the efficacy of nonsurgical treatment for most patients with LA and illustrate minor variation in LA management between PAG and PUR.</div></div>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":"281 ","pages":"Article 114529"},"PeriodicalIF":3.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588254","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